Bupha-Intr Olivia, Rose Sally B, Lawton Beverley A, Elley C Raina, Dowell Anthony C
Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
N Z Med J. 2010 Feb 19;123(1309):26-36.
To determine whether use of cardiovascular medications by a sample of mid-life and older women is consistent with New Zealand cardiovascular risk guidelines.
Retrospective analysis of risk factor data collected during the Women's Lifestyle Study involving 1089 40-74 year old women. Outcome measures included: 5-year cardiovascular (CVD) risk score calculated using the adjusted Framingham equation and self-reported use of cardiovascular medications.
Seven percent (76/1089) of women had established CVD, and a further 3% (33/1089) had a risk score greater than 15% (high risk). Of the 109 women at high risk (risk score = or >15% or established CVD); 36% (39/109) were taking aspirin, 55% (60/109) were taking blood pressure-lowering medication, 45% (49/109) were taking lipid-lowering medications and 17% (19/109) were taking all three medications. Triple therapy was being taken by 12% of women (4/33) for primary prevention (5-year risk score = or >15%) and only 19.7% of women for secondary prevention (15/76).
These results suggest that women at high-risk are not receiving cardiovascular medications as recommended by the guidelines, reflecting a 'treatment gap.' Modifiable barriers to the management of women at risk for CVD need to be identified and addressed to reduce cardiovascular morbidity and mortality among women.
确定中年及老年女性样本使用心血管药物的情况是否符合新西兰心血管疾病风险指南。
对在女性生活方式研究中收集的1089名40 - 74岁女性的风险因素数据进行回顾性分析。结果指标包括：使用调整后的弗雷明汉方程计算的5年心血管疾病（CVD）风险评分以及自我报告的心血管药物使用情况。
7%（76/1089）的女性已确诊患有心血管疾病，另有3%（33/1089）的女性风险评分大于15%（高危）。在109名高危女性（风险评分=或>15%或已确诊心血管疾病）中，36%（39/109）正在服用阿司匹林，55%（60/109）正在服用降压药物，45%（49/109）正在服用降脂药物，17%（19/109）正在服用所有三种药物。12%的女性（4/33）接受三联疗法用于一级预防（5年风险评分=或>15%），而用于二级预防的女性仅为19.7%（15/76）。
这些结果表明，高危女性未按照指南建议接受心血管药物治疗，这反映出存在“治疗差距”。需要识别并解决心血管疾病高危女性管理中可改变的障碍，以降低女性心血管疾病的发病率和死亡率。
