Gender differences in evidence-based pharmacological therapy for patients with stable coronary heart disease

Background: Women have a higher morbidity and mortality than men after an acute coronary event. We analyzed the prescription rates of evidence-based pharmacological therapies for patients with stable coronary heart disease and whether there were any differences with respect to gender. Design: This cross-sectional study evaluated 8817 patients, 26.3% women, receiving attention from 1799 family doctors in primary care centers (PCC) throughout Spain, and who had had a coronary event requiring hospitalization in the previous 6 months to 10 years. Results: Mean age was 65.4 years and a mean time-lapse since hospitalization of 37.4 months. In the overall population, prescription medications were: antiplatelet drugs in 80.5% of patients, 79% statins, 66% blockers of the angiotensin-renin system ( BARS) and 47% beta-blockers. Males received less cardiovascular disease medications than females (4.3 +/- 1.5 versus 4.6 +/- 1.6, respectively; p < 0.001), but when adjusted for risk factors the significance was lost (p=0.231). Following adjustment for risk factors and for co-morbidities, the use of diuretics was significantly higher in women while beta-blockers and statins were higher in men. The triple combination of antithrombotics, betablockers and statins was used in 41.4% (43.8% males versus 34.6% females; p < 0.001) while 24.3% used this triple combination plus a BARS; without significant difference between the genders. Conclusions: An important percentage of patients with stable coronary disease, particularly women, attended-to in primary care do not receive medications that have been shown to decrease the morbido-mortality of cardiovascular disease. (c) 2008 Elsevier Ireland Ltd. All rights reserved.