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Sex Differences in Cardiac Risk Factors, Perceived Risk, and Health Care Provider Discussion of Risk and Risk
Erica C Leifheit-Limson1, Gail D'Onofrio2, Mitra Daneshvar1
1Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
Insights
Young patients hospitalized for acute myocardial infarction (AMI) often have cardiac risk factors but lack awareness. Women with AMI were less likely than men to discuss cardiac risk and modification with healthcare providers.
Area of Science:
- Cardiology
- Public Health
- Gender Studies
Background:
- Sex differences in cardiac risk factors, risk perception, and healthcare provider discussions among young acute myocardial infarction (AMI) patients are understudied.
- Young AMI patients often present with multiple cardiac risk factors, necessitating a deeper understanding of their awareness and communication with healthcare providers.
Purpose of the Study:
- To compare the prevalence of cardiac risk factors, self-perceived risk, and healthcare provider discussions about heart disease and risk modification between young women and men hospitalized with AMI.
- To identify potential sex-based disparities in risk communication and awareness following an AMI event in young adults.
Main Methods:
- Analysis of 3,501 AMI patients aged 18-55 from the VIRGO study (US and Spanish hospitals, 2008-2012).
- Comparison of the prevalence of five cardiac risk factors by sex.
- Modified Poisson regression used to assess sex differences in self-perceived risk and reported provider discussions on risk and modification.
Main Results:
- Nearly all young AMI patients (98%) had at least one cardiac risk factor, with 64% having three or more.
- Only 53% perceived themselves at risk, and fewer reported provider discussions (46% told they were at risk, 49% discussed risk modification).
- Women were significantly less likely than men to be informed about their cardiac risk (RR: 0.89) or discuss risk modification (RR: 0.84).
Conclusions:
- A significant gap exists in risk awareness among young AMI patients, with only half perceiving themselves at risk before the event.
- Communication regarding cardiac risk and modification strategies with healthcare providers is infrequent and more limited for women.
- These findings highlight the need for improved risk communication and targeted interventions for young women post-AMI.
Background:
Differences between sexes in cardiac risk factors, perceptions of cardiac risk, and health care provider discussions about risk among young patients with acute myocardial infarction (AMI) are not well studied.
Objectives:
This study compared cardiac risk factor prevalence, risk perceptions, and health care provider feedback on heart disease and risk modification between young women and men hospitalized with AMI.
Methods:
We studied 3,501 AMI patients age 18 to 55 years enrolled in the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study in U.S. and Spanish hospitals between August 2008 and January 2012, comparing the prevalence of 5 cardiac risk factors by sex. Modified Poisson regression was used to assess sex differences in self-perceived heart disease risk and self-reported provider discussions of risk and modification.
Results:
Nearly all patients (98%) had ≥1 risk factor, and 64% had ≥3. Only 53% of patients considered themselves at risk for heart disease, and even fewer reported being told they were at risk (46%) or that their health care provider had discussed heart disease and risk modification (49%). Women were less likely than men to be told they were at risk (relative risk: 0.89; 95% confidence interval: 0.84 to 0.96) or to have a provider discuss risk modification (relative risk: 0.84; 95% confidence interval: 0.79 to 0.89). There was no difference between women and men for self-perceived risk.
Conclusions:
Despite having significant cardiac risk factors, only one-half of young AMI patients believed they were at risk for heart disease before their event. Even fewer discussed their risks or risk modification with their health care providers; this issue was more pronounced among women.
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