Gender disparities in blood pressure control and cardiovascular care in a national sample of ambulatory care visits
Gender disparities in blood pressure control and cardiovascular care in a national sample of ambulatory care visits
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DOI：
10.1161/hypertensionaha.107.107342
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发表时间：
2008-04-01
期刊：
影响因子：
8.3
通讯作者：
McLaughlin, Mary Ann
中科院分区：
文献类型：
--
作者：
Keyhani, Salomeh;Scobie, Janice V.;McLaughlin, Mary Ann
本研究的目的是分析美国各地门诊高血压和心血管疾病护理的性别差异。利用2005年全国门诊医疗调查和全国医院门诊医疗调查的数据，我们对患者与初级保健提供者的就诊情况进行了横断面分析，并检查了性别与血压控制、使用任何降压药物或对未控制的高血压患者开始新治疗以及接受特定心血管疾病推荐治疗之间的关系。估计多变量模型来检查性别和控制其他变量的每个结果之间的关系。共有12064名患者就诊（7786名女性和4278名男性）。在高血压患者中，女性达到血压控制目标的可能性低于男性（54.0%比58.7%;P < 0.02）。在多变量分析中，65 - 80岁的女性患高血压的可能性低于男性（优势比：0.62;95% CI: 0.45 - 0.85）。在未控制的高血压患者中，性别与使用任何抗高血压药物或开始新疗法之间没有关联。在多变量分析中，女性比男性更不可能接受阿司匹林（优势比：0.43;95% CI: 0.27至0.67）和受体阻滞剂（优势比：0.60;95% CI: 0.36至0.99）用于心血管疾病的二级预防。我们的研究强调了在血压控制和心血管疾病管理方面持续存在的性别差异，也揭示了对所有患者心血管护理的不足。
The purpose of this study was to provide an analysis of gender-based disparities in hypertension and cardiovascular disease care in ambulatory practices across the United States. Using data from the 2005 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, we conducted a cross-sectional analysis of patient visits with their primary care providers and examined the association between gender and blood pressure control, use of any antihypertensive medication or initiation of new therapy for patients with uncontrolled hypertension, and receipt of recommended therapy for select cardiovascular conditions. Multivariable models were estimated to examine the association between gender and each outcome controlling for other variables. A total of 12 064 patient visits were identified (7786 women and 4278 men). Among patients with hypertension, women were less likely than men to meet blood pressure control targets (54.0% versus 58.7%; P < 0.02). In multivariate analyses, women aged 65 to 80 years were less likely than men to have controlled hypertension (odds ratio: 0.62; 95% CI: 0.45 to 0.85). There was no association between gender and use of any antihypertensive medication or initiating a new therapy among patients with uncontrolled hypertension. In multivariate analyses, women were less likely than men to receive aspirin (odds ratio: 0.43; 95% CI: 0.27 to 0.67) and beta-blockers (odds ratio: 0.60; 95% CI: 0.36 to 0.99) for secondary prevention of cardiovascular disease. Our study highlights the persistent gender disparities in blood pressure control and cardiovascular disease management and also reveals the inadequate delivery of cardiovascular care to all patients.