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Improve uptake of heart disease guidelines in women, study recommends

Improvements need to be made in the uptake of guideline-recommended care for coronary heart disease in women as they are less likely to achieve treatment targets for secondary prevention than men, according to the findings of a new study.

Women with established coronary heart disease were less likely to achieve lower cholesterol and glucose levels and also less likely to be physically active than their male counterparts.

A team of international researchers looked at data from just over 10,000 patients with coronary heart disease from Europe, Asia and the Middle East, 29% of whom were women. They found that women were 50% less likely than men to achieve total cholesterol targets, 43% less likely to achieve LDL-cholesterol targets and 22% less likely to achieve glucose targets.

Women were also less likely than men to be physically active and to attend cardiac rehabilitation than men and were just under 20% less likely to have an adequate cardiovascular health index score, a measure of overall risk factor management.

The researchers noted that sex differences in achieving lipid targets were larger in younger women compared to older women, leaving younger patients at a particular disadvantage. They also found that the distribution of disease category differed between men and women, with fewer women recruited who had had a surgical intervention (CABG) for their heart disease.

The researchers said in the paper: ‘Our findings revealed differential distribution of CHD category between women and men and fewer female CABG patients were recruited. As such, women may pay less attention to their CHD risk factor management, resulting in less cardiovascular medication being used and fewer targets being achieved by women.

‘This is unfortunate as clinical guidelines recommend, based on evidence from large randomised controlled trials, the use of preventative medications and a strategy of CHD prevention for all CHD patients, irrespective of age, sex, or severity of disease.

‘Sex disparities in risk factor management differed across regions, suggesting the need for tailored strategies to reduce these inequalities and to improve the uptake of guideline-recommended care for the secondary prevention of CHD in both men and women.’

BMJ 2017; avaliable online 20th September


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