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瑞典初级医疗保健中接受治疗的高血压患者的医生性别与危险因素控制的关联

Association of physician's sex with risk factor control in treated hypertensive patients from Swedish primary healthcare.

作者信息

Journath Gunilla, Hellénius Mai-Lis, Manhem Karin, Kjellgren Karin I, Nilsson Peter M

机构信息

Department of Medicine, Clinical Epidemiology unit, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden.

出版信息

J Hypertens. 2008 Oct;26(10):2050-6. doi: 10.1097/HJH.0b013e32830a4a3b.

Abstract

OBJECTIVE

To study the association of physician's sex with blood pressure, lipid control, and cardiovascular risk factors in treated hypertensive men and women, stratified for the sex of their physician.

METHODS

In a cross-sectional survey of hypertensive patients, 264 primary care physicians (PCPs), 187 men and 77 women from across Sweden, recruited 6537 treated hypertensive patients (48% men) during 2002-2005, consecutively collected from medical records and registered on a web-based form connected to a central database. Patients were included consecutively in the same order as they visited the healthcare centre.

RESULTS

Hypertensive women more often reached target systolic/diastolic blood pressure levels (<140/90 mmHg) when treated by female PCPs than when they were treated by male PCPs (32 vs. 24%, P < 0.001). This difference remained when comparing female and male physicians' nondiabetic female patients. Both male and female patients had better control of total cholesterol and low-density lipoprotein cholesterol levels when treated by female PCPs than when treated by male PCPs (total cholesterol <5 mmol/l: women 30 vs. 24%, P < 0.001; men 42 vs. 34%, P < 0.001; low-density lipoprotein cholesterol <3 mmol/l: women 39 vs. 33%, P < 0.01; men 41 vs. 35%, P < 0.05). Female PCPs had a higher proportion of treated hypertensive patients with diabetes than did male PCPs but male PCPs had a higher prevalence of treated hypertensive men with microalbuminuria compared with female PCPs.

CONCLUSION

Female physicians appeared more often to reach the treatment goal for blood pressure in female patients and cholesterol levels in all patients than did male physicians.

摘要

目的

研究在接受治疗的高血压男性和女性患者中,医生性别与血压、血脂控制及心血管危险因素之间的关联,并按医生性别进行分层分析。

方法

在一项针对高血压患者的横断面调查中,来自瑞典各地的264名初级保健医生(PCP),其中187名男性和77名女性,在2002年至2005年期间招募了6537名接受治疗的高血压患者(48%为男性),这些患者的信息从病历中连续收集,并登记在与中央数据库相连的基于网络的表格上。患者按照他们就诊医疗中心的顺序依次纳入研究。

结果

与男性初级保健医生治疗的高血压女性患者相比,由女性初级保健医生治疗的高血压女性患者更常达到目标收缩压/舒张压水平(<140/90 mmHg)(32%对24%,P<0.001)。在比较男性和女性医生治疗的非糖尿病女性患者时,这种差异仍然存在。与男性初级保健医生治疗的患者相比,由女性初级保健医生治疗的男性和女性患者的总胆固醇和低密度脂蛋白胆固醇水平控制得更好(总胆固醇<5 mmol/l:女性为30%对24%,P<0.001;男性为42%对34%,P<0.001;低密度脂蛋白胆固醇<3 mmol/l:女性为39%对33%,P<0.01;男性为41%对35%,P<0.05)。女性初级保健医生治疗的高血压糖尿病患者比例高于男性初级保健医生,但与女性初级保健医生相比,男性初级保健医生治疗的高血压男性微量白蛋白尿患病率更高。

结论

与男性医生相比,女性医生似乎更常使女性患者达到血压治疗目标,并使所有患者达到胆固醇治疗目标。

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