Recommended heart medications prescribed less frequently to women
Women receiving treatment from a primary care clinician do not always receive the recommended medications to prevent a heart attack, according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.
“Additional efforts need to be taken to ensure that everyone, women and men, who should receive heart attack medications actually is prescribed these medications,” said study lead Dr Sanne Peters, Research Fellow in Epidemiology at The George Institute for Global Health, UK and Associate Professor at the University Medical Center, Utrecht. “We also need to reduce the persistent treatment gaps between women and men.”
Cardiovascular disease is the leading cause of death worldwide. Lifestyle changes including maintaining a healthy weight, quitting smoking, being physically active, eating a healthy diet, controlling high blood pressure and cholesterol, and reducing high blood sugar can lower heart disease risk. “For some people, however, medication also may be necessary to reduce risk,” Peters noted.
Previous research among heart attack survivors found that women were less likely to receive recommended medications in a hospital setting. In this study, researchers wanted to understand whether this occurs even earlier, in primary care, among patients at risk for a first or a repeat heart attack.
A systematic review of two large medical databases was conducted to find studies with data showing the number of heart-disease prescriptions among women and men. Researchers looked specifically for studies with data on statin prescriptions, which lower cholesterol; aspirin, which decreases the risk of blood clots; and blood-pressure lowering drugs, including ACE-inhibitors and diuretics.
A total of 43 international studies with data on primary-care prescriptions among more than 2.2 million patients (28% women, average age 51-76 years) who were at risk for heart attack were evaluated. Among the findings, the analysis indicates women received:
- 19% fewer statin prescriptions than men;
- 10% fewer aspirin prescriptions than men; and
- 15% fewer ACE-inhibitor prescriptions than men.
At the same time, however, women were 27% more likely than men to be prescribed diuretics.
“Patients should talk with their clinicians about the benefits of using heart disease medications and weigh them against the potential risks,” Peters said.
This analysis had limitations. For example, it could not control for differences in the 43 separate studies, and there was limited information about combined medications or other diseases in addition to heart disease. Finally, the researchers examined sex differences in prescriptions only, not the effects of these differences on heart attack risk.
The Netherlands Organization for Scientific Research, the National Health and Medical Research Council, the Dutch Heart Foundation, the National Heart Foundation Australia and the UK Medical Research Council supported the study.