性差异在药理学最佳医疗治疗缺血性心脏病,2010-2020年:一个观察性研究
Hassan A Alhassan1, Harnoor Mann2, Leonard Chiu3
1Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
medRxiv : the preprint server for health sciences
|July 17, 2025
概括
患有缺血性心脏病 (IHD) 的女性接受的医疗治疗 (OMT) 比男性少,抗血小板,他类药物和RAASi在十年内使用的持续性差异. 需要有针对性的策略来改善妇女的心血管预防.
科学领域:
- 心血管医学 心血管医学
- 健康差异 在健康上的差异
- 预防性心脏病学 预防性心脏病学
背景情况:
- 指南推的缺血性心脏病 (IHD) 的最佳医疗疗法 (OMT) 包括抗血小板药物,他类药物,RAASi和β-阻断剂.
- 在OMT使用方面,有实质性的性别差异已被记录下来.
- 国家努力减轻当代群体中这些差异的影响仍然不清楚.
研究的目的:
- 评估OMT用于二次预防IHD的当代趋势.
- 评估OMT使用和指南推的组合中的基于性别的差异.
- 为了确定这些差异是否在过去十年中发生了变化.
主要方法:
- 2011-2020年国家健康和营养检查调查 (NHANES) 数据的分析.
- 包括自我报告的IDH (心肌梗塞或冠心病病史) 的成人.
- 通过自我报告和药物验证评估OMT使用 (抗血小板药物,他类药物,RAASi,β抑制剂),按性别分层.
主要成果:
- 在1,905名成年人中,女性的OMT使用率较低:抗血小板药 (68.0%vs77.7%),他类药物 (57.2%vs73.9%),RAASi (45.6%vs59.0%) 和β-阻断剂 (51.2%vs61.1%).
- 妇女不太可能使用指南推的组合,包括阿司匹林加上他类药物 (47.4% vs 64.1%) 和所有四个OMT类 (17.5% vs 32.5%).
- 经过调整后的分析显示,女性仍然不太可能使用抗血小板药物,他类药物和RAASi,在2011-2020年之间存在一致的差异.
结论:
- 患有IHD的女性接受指导方针指导的OMT的可能性明显低于男性.
- 在过去的十年中,在IMD二次预防中使用OMT存在持续的基于性别的差异.
- 有针对性的战略对于解决和缩小心血管预防中的性别差距至关重要.
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