Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta‐Analysis
Background Sex differences in the management of cardiovascular disease have been reported in secondary care. We conducted a systematic review with meta‐analysis of systematically investigated sex differences in cardiovascular medication prescription among patients at high risk or with established ca...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.014742 |
| _version_ | 1818775651636740096 |
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| author | Min Zhao Mark Woodward Ilonca Vaartjes Elizabeth R. C. Millett Kerstin Klipstein‐Grobusch Karice Hyun Cheryl Carcel Sanne A. E. Peters |
| author_facet | Min Zhao Mark Woodward Ilonca Vaartjes Elizabeth R. C. Millett Kerstin Klipstein‐Grobusch Karice Hyun Cheryl Carcel Sanne A. E. Peters |
| author_sort | Min Zhao |
| collection | DOAJ |
| description | Background Sex differences in the management of cardiovascular disease have been reported in secondary care. We conducted a systematic review with meta‐analysis of systematically investigated sex differences in cardiovascular medication prescription among patients at high risk or with established cardiovascular disease in primary care. Methods and Results PubMed and Embase were searched between 2000 and 2019 for observational studies reporting on the sex‐specific prevalence of aspirin, statins, and antihypertensive medication prescription, including beta blockers, calcium channel blockers, angiotensin‐converting enzyme inhibitors, and diuretics, in primary care. Random effects meta‐analysis was used to obtain pooled women‐to‐men prevalence ratios for each cardiovascular medication prescription. Metaregression models assessed the impact of age and year on the findings. A total of 43 studies were included, involving 2 264 600 participants (28% women) worldwide. Participants’ mean age ranged from 51 to 76 years. The pooled prevalence of cardiovascular medication prescription for women was 41% for aspirin, 60% for statins, and 68% for any antihypertensive medications. Corresponding rates for men were 56%, 63%, and 69% respectively. The pooled women‐to‐men prevalence ratios were 0.81 (95% CI, 0.72–0.92) for aspirin, 0.90 (95% CI, 0.85–0.95) for statins, and 1.01 (95% CI, 0.95–1.08) for any antihypertensive medications. Women were less likely to be prescribed angiotensin‐converting enzyme inhibitors (0.85; 95% CI, 0.81–0.89) but more likely with diuretics (1.27; 95% CI, 1.17–1.37). Mean age, mean age difference between the sexes, and year of study had no significant impact on findings. Conclusions Sex differences in the prescription of cardiovascular medication exist among patients at high risk or with established cardiovascular disease in primary care, with a lower prevalence of aspirin, statins, and angiotensin‐converting enzyme inhibitors prescription in women and a lower prevalence of diuretics prescription in men. |
| first_indexed | 2024-12-18T11:00:26Z |
| format | Article |
| id | doaj.art-b5511a7a3f094403b8c3bf7f4dd7115f |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-18T11:00:26Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b5511a7a3f094403b8c3bf7f4dd7115f2022-12-21T21:10:14ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-06-0191110.1161/JAHA.119.014742Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta‐AnalysisMin Zhao0Mark Woodward1Ilonca Vaartjes2Elizabeth R. C. Millett3Kerstin Klipstein‐Grobusch4Karice Hyun5Cheryl Carcel6Sanne A. E. Peters7Julius Global Health Julius Centre for Health Sciences and Primary Care Utrecht Medical Centre Utrecht University Utrecht NetherlandsThe George Institute for Global Health University of Oxford United KingdomJulius Global Health Julius Centre for Health Sciences and Primary Care Utrecht Medical Centre Utrecht University Utrecht NetherlandsThe George Institute for Global Health University of Oxford United KingdomJulius Global Health Julius Centre for Health Sciences and Primary Care Utrecht Medical Centre Utrecht University Utrecht NetherlandsFaculty of Medicine and Health Westmead Applied Research Centre University of Sydney AustraliaThe George Institute for Global Health University of New South Wales Sydney AustraliaJulius Global Health Julius Centre for Health Sciences and Primary Care Utrecht Medical Centre Utrecht University Utrecht NetherlandsBackground Sex differences in the management of cardiovascular disease have been reported in secondary care. We conducted a systematic review with meta‐analysis of systematically investigated sex differences in cardiovascular medication prescription among patients at high risk or with established cardiovascular disease in primary care. Methods and Results PubMed and Embase were searched between 2000 and 2019 for observational studies reporting on the sex‐specific prevalence of aspirin, statins, and antihypertensive medication prescription, including beta blockers, calcium channel blockers, angiotensin‐converting enzyme inhibitors, and diuretics, in primary care. Random effects meta‐analysis was used to obtain pooled women‐to‐men prevalence ratios for each cardiovascular medication prescription. Metaregression models assessed the impact of age and year on the findings. A total of 43 studies were included, involving 2 264 600 participants (28% women) worldwide. Participants’ mean age ranged from 51 to 76 years. The pooled prevalence of cardiovascular medication prescription for women was 41% for aspirin, 60% for statins, and 68% for any antihypertensive medications. Corresponding rates for men were 56%, 63%, and 69% respectively. The pooled women‐to‐men prevalence ratios were 0.81 (95% CI, 0.72–0.92) for aspirin, 0.90 (95% CI, 0.85–0.95) for statins, and 1.01 (95% CI, 0.95–1.08) for any antihypertensive medications. Women were less likely to be prescribed angiotensin‐converting enzyme inhibitors (0.85; 95% CI, 0.81–0.89) but more likely with diuretics (1.27; 95% CI, 1.17–1.37). Mean age, mean age difference between the sexes, and year of study had no significant impact on findings. Conclusions Sex differences in the prescription of cardiovascular medication exist among patients at high risk or with established cardiovascular disease in primary care, with a lower prevalence of aspirin, statins, and angiotensin‐converting enzyme inhibitors prescription in women and a lower prevalence of diuretics prescription in men.https://www.ahajournals.org/doi/10.1161/JAHA.119.014742cardiovascular medicationmeta‐analysisprimary caresex differencessystematic review |
| spellingShingle | Min Zhao Mark Woodward Ilonca Vaartjes Elizabeth R. C. Millett Kerstin Klipstein‐Grobusch Karice Hyun Cheryl Carcel Sanne A. E. Peters Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta‐Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular medication meta‐analysis primary care sex differences systematic review |
| title | Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta‐Analysis |
| title_full | Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta‐Analysis |
| title_fullStr | Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta‐Analysis |
| title_full_unstemmed | Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta‐Analysis |
| title_short | Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta‐Analysis |
| title_sort | sex differences in cardiovascular medication prescription in primary care a systematic review and meta analysis |
| topic | cardiovascular medication meta‐analysis primary care sex differences systematic review |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.014742 |
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