Women Less Likely to Receive Heart Meds in Primary Care

By Megan Brooks

May 22, 2020

NEW YORK (Reuters Health) - There are clear gender differences in the medication prescribed in primary care to adults with or at high risk for heart disease, with women less apt than men to receive aspirin and statins, a new study indicates.

"Our study shows that there a lot of people who do not receive guideline-recommended medications, and this gap is even larger for women than for men for some medications," Dr. Sanne Peters of the University of Oxford, in the U.K., and University Medical Center Utrecht, in the Netherlands, told Reuters Health by email.

Previous studies have shown that women are less likely than men to receive guideline-recommended medication following a heart attack. These treatment gaps have largely been studied in a hospital setting, Dr. Peters explained.

"What was not known is whether similar sex differences exist in the treatment given in a primary-care setting, not only to people who have survived a heart attack, but also to those who are a high-risk of a heart attack," she said.

To investigate, she and her colleagues analyzed data from 43 studies involving more than 2.2 million middle-aged and older adults (28% women) at high risk for or with established heart disease in primary care.

Women were less likely than men to receive cholesterol-lowering statins (60% vs. 63%), aspirin (41% vs. 56%) and any antihypertensive medications (68% vs. 69%), the researchers report in the Journal of the American Heart Association.

Based on these results, women were 19% less likely to be prescribed aspirin (women-to-men prevalence ratio, 0.81; 95% confidence interval, 0.72 to 0.92) and 10% less apt to be prescribed statins, (PR, 0.90; 95% CI, 0.85 to 0.95). There was no significant difference for antihypertensives overall.

Women were also 15% less likely than men to receive angiotensin-converting enzyme (ACE) inhibitors (PR, 0.85; 95% CI, 0.81 to 0.89) but 27% more likely to receive diuretics (PR, 1.27; 95% CI, 1.17 to 1.37). There were no sex differences in the prescription of beta-blockers or calcium-channel blockers.

"Additional efforts need to be taken to ensure that everyone who should receive heart attack medications actually receives these medications," Dr. Peters told Reuters Health.

"We also need to reduce the persistent treatment gaps between women and men. Patients should talk with their physicians about the benefits of using heart disease medications, and weigh them against the potential risks," she added.

The study had no commercial funding and the authors have indicated no relevant conflicts of interest.

SOURCE: https://bit.ly/2z7Qg2u Journal of the American Heart Association, online May 20, 2020.