Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional study
Background: Diabetes is a stronger risk factor for cardiovascular complications in women than men. Aim: To evaluate whether there are sex differences in cardiovascular risk management in patients with diabetes in primary care. Design & setting: A cross-sectional study was undertaken using data f...
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| Format: | Article |
| Language: | English |
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Royal College of General Practitioners
2019-01-01
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| Series: | BJGP Open |
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| Online Access: | https://bjgpopen.org/content/3/2/bjgpopen19X101645 |
| _version_ | 1819204336073310208 |
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| author | Marit de Jong Rimke C Vos Rianneke de Ritter Carla J van der Kallen Simone J Sep Mark Woodward Coen DA Stehouwer Michiel L Bots Sanne AE Peters |
| author_facet | Marit de Jong Rimke C Vos Rianneke de Ritter Carla J van der Kallen Simone J Sep Mark Woodward Coen DA Stehouwer Michiel L Bots Sanne AE Peters |
| author_sort | Marit de Jong |
| collection | DOAJ |
| description | Background: Diabetes is a stronger risk factor for cardiovascular complications in women than men. Aim: To evaluate whether there are sex differences in cardiovascular risk management in patients with diabetes in primary care. Design & setting: A cross-sectional study was undertaken using data from 12 512 individuals with diabetes within the Dutch Julius General Practitioners Network (JGPN) from 2013. Method: Linear and Poisson regression analyses were used to assess sex differences in risk factor levels, assessment, treatment, and control. Results: No sex differences were found in HbA1c levels and control, while small differences were found for cardiovascular risk management. Blood pressure levels were higher (mean difference [MD] 1.09 mmHg; 95% confidence intervals [CI] = 0.41 to 1.77), while cholesterol levels (MD -0.38 mmol/l; 95% CI = -0.42 to -0.34) and body mass index ([BMI] MD -1.79 kg/m2; 95% CI = -2.03 to 1.56) were lower in men than women. Risk factor assessment was similar between sexes, apart from high-density lipoprotein cholesterol (HDL-c), which was more commonly assessed in women (risk ratio [RR] 1.16; 95% CI = 1.13 to 1.20). Among those with a treatment indication for prevention, women with cardiovascular disease (CVD) were less likely to receive lipid-lowering drugs (RR 0.84; 95% CI = 0.76 to 0.93) than men, while women without CVD were more likely to receive lipid-lowering drugs (RR 1.16; 95% CI = 1.04 to 1.2). Among those treated, women were more likely to achieve systolic blood pressure (SBP) control (RR 1.06; 95% CI = 1.02 to 1.10) and less likely to achieve low-density lipoprotein cholesterol (LDL-c) control (RR 0.88; 95% CI = 0.85 to 0.91) than men. Conclusion: In this Dutch primary care setting, sex differences in risk factor assessment and treatment of people with diabetes were small. However, women with diabetes were less likely to achieve control for LDL-c and more likely to achieve blood pressure control than men with diabetes. |
| first_indexed | 2024-12-23T04:34:11Z |
| format | Article |
| id | doaj.art-f02e110d0bb54f41af73be3e92e46fcb |
| institution | Directory Open Access Journal |
| issn | 2398-3795 |
| language | English |
| last_indexed | 2024-12-23T04:34:11Z |
| publishDate | 2019-01-01 |
| publisher | Royal College of General Practitioners |
| record_format | Article |
| series | BJGP Open |
| spelling | doaj.art-f02e110d0bb54f41af73be3e92e46fcb2022-12-21T17:59:57ZengRoyal College of General PractitionersBJGP Open2398-37952019-01-013210.3399/bjgpopen19X101645Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional studyMarit de Jong0Rimke C Vos1Rianneke de Ritter2Carla J van der Kallen3Simone J Sep4Mark Woodward5Coen DA Stehouwer6Michiel L Bots7Sanne AE Peters8Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsDepartment of Public Health and Primary Care / LUMC-Campus, Leiden University Medical Center, The Hague, The NetherlandsDepartment of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The NetherlandsThe George Institute for Global Health, University of Oxford, Oxford, UKDepartment of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The NetherlandsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsBackground: Diabetes is a stronger risk factor for cardiovascular complications in women than men. Aim: To evaluate whether there are sex differences in cardiovascular risk management in patients with diabetes in primary care. Design & setting: A cross-sectional study was undertaken using data from 12 512 individuals with diabetes within the Dutch Julius General Practitioners Network (JGPN) from 2013. Method: Linear and Poisson regression analyses were used to assess sex differences in risk factor levels, assessment, treatment, and control. Results: No sex differences were found in HbA1c levels and control, while small differences were found for cardiovascular risk management. Blood pressure levels were higher (mean difference [MD] 1.09 mmHg; 95% confidence intervals [CI] = 0.41 to 1.77), while cholesterol levels (MD -0.38 mmol/l; 95% CI = -0.42 to -0.34) and body mass index ([BMI] MD -1.79 kg/m2; 95% CI = -2.03 to 1.56) were lower in men than women. Risk factor assessment was similar between sexes, apart from high-density lipoprotein cholesterol (HDL-c), which was more commonly assessed in women (risk ratio [RR] 1.16; 95% CI = 1.13 to 1.20). Among those with a treatment indication for prevention, women with cardiovascular disease (CVD) were less likely to receive lipid-lowering drugs (RR 0.84; 95% CI = 0.76 to 0.93) than men, while women without CVD were more likely to receive lipid-lowering drugs (RR 1.16; 95% CI = 1.04 to 1.2). Among those treated, women were more likely to achieve systolic blood pressure (SBP) control (RR 1.06; 95% CI = 1.02 to 1.10) and less likely to achieve low-density lipoprotein cholesterol (LDL-c) control (RR 0.88; 95% CI = 0.85 to 0.91) than men. Conclusion: In this Dutch primary care setting, sex differences in risk factor assessment and treatment of people with diabetes were small. However, women with diabetes were less likely to achieve control for LDL-c and more likely to achieve blood pressure control than men with diabetes.https://bjgpopen.org/content/3/2/bjgpopen19X101645primary health caresex characteristicsdiabetes mellituscardiovascular risk managementgeneral practice |
| spellingShingle | Marit de Jong Rimke C Vos Rianneke de Ritter Carla J van der Kallen Simone J Sep Mark Woodward Coen DA Stehouwer Michiel L Bots Sanne AE Peters Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional study BJGP Open primary health care sex characteristics diabetes mellitus cardiovascular risk management general practice |
| title | Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional study |
| title_full | Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional study |
| title_fullStr | Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional study |
| title_full_unstemmed | Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional study |
| title_short | Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional study |
| title_sort | sex differences in cardiovascular risk management for people with diabetes in primary care a cross sectional study |
| topic | primary health care sex characteristics diabetes mellitus cardiovascular risk management general practice |
| url | https://bjgpopen.org/content/3/2/bjgpopen19X101645 |
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