Journal article
Sex Differences in the Use of Statins in Community Practice Patient and Provider Assessment of Lipid Management Registry
Circulation Cardiovascular quality and outcomes, Vol.12(8), pp.e005562-e005562
08/01/2019
DOI: 10.1161/CIRCOUTCOMES.118.005562
PMCID: PMC6903404
PMID: 31416347
Abstract
Background: Female patients have historically received less aggressive lipid management than male patients. Contemporary care patterns and the potential causes for these differences are unknown. Methods and Results: Examining the Patient and Provider Assessment of Lipid Management Registry-a nationwide registry of outpatients with or at risk for atherosclerotic cardiovascular disease-we compared the use of statin therapy, guideline-recommended statin dosing, and reasons for undertreatment. We specifically analyzed sex differences in statin treatment and guideline-recommended statin dosing using multivariable logistic regression. Among 5693 participants (43% women) eligible for 2013 American College of Cardiology/American Heart Association Cholesterol Guideline-recommended statin treatment, women were less likely than men to be prescribed any statin therapy (67.0% versus 78.4%; P<0.001) or to receive a statin at the guideline-recommended intensity (36.7% versus 45.2%; P<0.001). Women were more likely to report having previously never been offered statin therapy (18.6% versus 13.5%; P<0.001), declined statin therapy (3.6% versus 2.0%; P<0.001), or discontinued their statin (10.9% versus 6.1%; P<0.001). Women were also less likely than men to believe statins were safe (47.9% versus 55.2%; P<0.001) or effective (68.0% versus 73.2%; P<0.001) and more likely to report discontinuing their statin because of a side effect (7.9% versus 3.6%; P<0.001). Sex differences in both overall and guideline-recommended intensity statin use persisted after adjustment for demographics, socioeconomic factors, clinical characteristics, patient beliefs, and provider characteristics (adjusted odds ratio, 0.70; 95% CI, 0.61-0.81; P<0.001; and odds ratio, 0.82; 95% CI, 0.73-0.92; P<0.01, respectively). Sex differences were consistent across primary and secondary prevention indications for statin treatment. Conclusions: Women eligible for statin therapy were less likely than men to be treated with any statin or guideline-recommended statin intensity. A combination of women being offered statin therapy less frequently, while declining and discontinuing treatment more frequently, accounted for these sex differences in statin use.
Details
- Title: Subtitle
- Sex Differences in the Use of Statins in Community Practice Patient and Provider Assessment of Lipid Management Registry
- Creators
- Michael G. Nanna - Duke UniversityTracy Y. Wang - Duke UniversityQun Xiang - Duke UniversityAnne C. Goldberg - Washington University in St. LouisJennifer G. Robinson - University of IowaVeronique L. Roger - Mayo ClinicSalim S. Virani - Baylor College of MedicinePeter W. F. Wilson - Atlanta VA Medical CenterMichael J. Louie - RegeneronAndrew Koren - SanofiZhuokai Li - Duke UniversityEric D. Peterson - Duke UniversityAnn Marie Navar - Duke University
- Resource Type
- Journal article
- Publication Details
- Circulation Cardiovascular quality and outcomes, Vol.12(8), pp.e005562-e005562
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1161/CIRCOUTCOMES.118.005562
- PMID
- 31416347
- PMCID
- PMC6903404
- ISSN
- 1941-7705
- eISSN
- 1941-7705
- Number of pages
- 10
- Grant note
- K01HL133416-01 / National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA T32HL069749 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) T-32-HL069749-15 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Regeneron Pharmaceuticals; Regeneron Sanofi Pharmaceuticals
- Language
- English
- Date published
- 08/01/2019
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984363626002771
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