Related Experiment Videos
Gender differences in antihypertensive drug treatment: results from the Swedish Primary Care Cardiovascular Database
Charlotta Ljungman1, Thomas Kahan2, Linus Schiöler3
1Department of Molecular and Clinical Medicine/Cardiology, Institute of Medicine, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Insights
Gender disparities exist in hypertension treatment, with women and men receiving different antihypertensive drugs not fully explained by comorbidities. Men more frequently discontinue angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, impacting treatment outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Gender-based differences in antihypertensive medication prescribing are documented.
- The influence of comorbidities on these observed gender treatment disparities requires elucidation.
- Understanding gender-specific blood pressure control and treatment adherence is crucial for effective hypertension management.
Purpose of the Study:
- To investigate if comorbidities explain gender differences in antihypertensive treatment.
- To compare blood pressure control between men and women with hypertension.
- To determine if women interrupt treatment with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) more often than men.
Main Methods:
- A cohort study utilizing the Swedish Primary Care Cardiovascular Database.
- Inclusion of 40,825 patients with hypertension from 2007 to 2008.
- Analysis of cardiovascular comorbidities, drug prescriptions, and treatment interruptions, stratified by gender.
Main Results:
- Cardiovascular comorbidities (excluding heart failure) were more prevalent in men.
- Women were more frequently prescribed diuretics, while men received ACEIs; hypertensive patients with diabetes also received ACEIs.
- Comorbidities did not fully account for gender differences in treatment; women exhibited higher systolic blood pressure, and men more frequently interrupted ACEI/ARB treatment.
Conclusions:
- Significant gender differences persist in antihypertensive drug selection, not entirely explained by comorbidities.
- Women consistently present with higher systolic blood pressure, regardless of comorbidity status.
- Higher rates of ACEI/ARB treatment interruption in men warrant further investigation due to potential impact on cardiovascular outcomes.
Abstract:
There are gender differences in antihypertensive treatment. This study aimed to investigate if gender differences in treatment could be explained by comorbidities. In addition, we aimed to study whether blood pressure control is different in women and men, and whether women interrupt treatment more often with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) compared with men.This cohort study within the Swedish Primary Care Cardiovascular Database included 40,825 patients with hypertension attending primary health care from 2007 to 2008. Cardiovascular comorbidities, with the exception of heart failure, were more common in men. Women were more often treated with diuretics, and men with ACEI, as were hypertensive patients with diabetes. Comorbidities could not entirely explain gender differences in antihypertensive treatment in a regression model. Women had higher systolic and lower diastolic blood pressure; this was also true in subgroups with cardiovascular comorbidity. Men more often than women were prescribed ACEIs/ARBs and interrupted treatment. Women and men are treated with different antihypertensive drugs, and this is not fully explained by differences in comorbidities. Women have higher systolic blood pressures, irrespective of comorbidity. Men have interrupted treatment more often with ACEIs/ARBs. These gender differences could affect outcome and warrant further investigation.