Gender-related cardiovascular health disparities in patients with Atherosclerotic Cardiovascular Disease

A novel study shows the worrying differences, sex-related, to care, follow-up, and adherence to treatment, in patients with Atherosclerotic Disease.

This was a cross-sectional, multicenter, health care system–based study with patients, across the USA, who have been enrolled in the Veterans with Premature Atherosclerosis (VITAL) registry. This exercise evaluated those patients who had at least one consultation with one of the units of the Veterans Administration, between October 1st, 2014, and September 30th, 2015.

The objective was to evaluate whether there are disparities concerning gender care, in terms of secondary prevention, in patients with premature (≤55 years) or extremely premature (≤40 years) Atherosclerotic Cardiovascular Disease (ASCVD). The study identified 10, 413 women and 137,187 men with premature ASCVD (≤55 years), and 1,340 women and 8,145 men with extremely premature ASCVD (≤40 years).

The researchers assessed specifically:

• Use of antiplatelet therapy. Drugs (such as aspirin) that prevent platelets from adhering to arterial irregularities.
• Use of any statin. Drugs that reduce the production and deposition of cholesterol in the arterial walls.
• Use of high doses of statins and adherence to treatment. The Proportion of days of treatment covered (PDC) /days of treatment indicated in patients with a history of    Cardiac, Cerebrovascular, or Peripheral Arterial Ischemic Disease.

Among the patients encompassing Ischemic Heart Disease (IHD), female presented the following characteristics:

• Received less antiplatelet therapy Adjusted Odds Ratio (AOR) [AOR] 0.47
• They took any statin [AOR] 0.62
• They took statin at high doses [AOR] 0.63
• And they adhered less to treatment than men PDC 0.68 +- 0.34 vs. 0.73+- 0.31

The same was observed in the case of Ischemic Cardiovascular Disease (ICVD), and Peripheral Disease (PAD). Women received less antiplatelet therapy, less treatment with any dose of statins, and less treatment with high doses of statins. In those patients with extremely Early atherosclerotic disease (≤40 years) women also received less antiplatelet therapy ([AOR] 0.61), less statin therapy at any dose ([AOR] 0.5), and less high-dose statin treatment ([AOR] 0.45).

This cross-sectional study reveals that veteran women are receiving sub- optimum treatment for primary prevention of early-onset cardiovascular disease and are also less attached to statin treatment,althoughits benefitsareclearly established. Sub-optimal use of Secondary Cardiovascular Prophylaxis in this group of young adults can result in devastating effects on their long-term health, with a considerable deterioration in their quality of life.

Will it have to do with the lack of awareness, both in the medical environment, and among the public, about the importance and implications of the problem?

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