Gender differences in lipid management, LDL-C goal attainment, and prescribing practices

Area of Science:

• Cardiology
• Health Disparities
• Pharmacotherapy

Background:

• Lipid lowering is crucial for reducing atherosclerotic cardiovascular disease (ASCVD) morbidity and mortality.
• Despite guideline-recommended therapies, gender disparities persist in lipid management.
• Women are less likely to receive aggressive treatment and achieve optimal low-density lipoprotein cholesterol (LDL-C) levels.

Purpose of the Study:

• To investigate if provider gender influences lipid treatment gaps.
• To analyze gender-based differences in lipid management and LDL-C goal attainment.

Main Methods:

• Retrospective chart review of 364,021 adults from 2022-2023.
• Abstraction of demographic, clinical, and prescribing data from electronic health records.
• Definition of optimal LDL-C based on ASCVD risk.

Main Results:

• Women had higher mean LDL-C (108 vs 102 mg/dL) and lower LDL-C <100 mg/dL attainment (41% vs 47%) compared to men.
• Among those with ASCVD, women had significantly lower LDL-C <70 mg/dL attainment (31% vs 47%).
• Women were less likely to be prescribed statins (26% vs 33%) and high-intensity statins (23% vs 31%) than men; provider gender showed no impact.

Conclusions:

• Women with or at risk for ASCVD experience lower rates of lipid-lowering therapy prescription and LDL-C goal attainment.
• Existing gender disparities in lipid management require targeted interventions.
• Provider gender does not explain the observed disparities in lipid treatment for women.