Departments of Medicine and Cardiology, University of Pennsylvania Health System, Pennsylvania Hospital, Philadelphia, Pennsylvania.
Biostatistics Analysis Center, University of Pennsylvania, Philadelphia, Pennsylvania.
Am J Cardiol. 2014 May 15;113(10):1611-5. doi: 10.1016/j.amjcard.2014.02.018. Epub 2014 Mar 1.
To investigate gender differences in lipid goal attainment, we conducted a retrospective analysis of outpatient electronic health records from a large cardiology practice from September 2008 to September 2009. The most recent lipid profile and lipid-lowering medications and doses were extracted from electronic medical record. We identified 9,950 patients with coronary artery disease of whom 3,366 (34%) were women. Women were less likely to achieve a low-density lipoprotein (LDL) cholesterol goal of <70 mg/dl compared with men (30.6% vs 38.4%, p <0.001) and less likely to achieve a non-high-density lipoprotein cholesterol goal of <100 mg/dl (37.1% vs 48.2%, p <0.001). Irrespective of age, women were less likely to achieve their LDL cholesterol goals. Compared with men, women were more likely to be on no statin (16.9% vs 11.6%, p <0.001) or any lipid-lowering therapy (12.8% vs 7.8%, p <0.001) and less likely to be on high-potency statin (14.9% vs 18.0%, p <0.001) or combination therapy (22.2% vs 30.1%, p <0.001). There exists a major difference in the use of lipid-lowering therapy between men and women with coronary artery disease. In conclusion, women with coronary artery disease are prescribed insufficient doses of statins and combination lipid-lowering therapy and are less likely to achieve their optimal LDL and non-high-density lipoprotein cholesterol goals.
为了研究血脂目标达标情况的性别差异,我们对一家大型心脏病学诊所 2008 年 9 月至 2009 年 9 月的门诊电子健康记录进行了回顾性分析。从电子病历中提取了最近的血脂谱和降脂药物及剂量。我们确定了 9950 例冠心病患者,其中 3366 例(34%)为女性。与男性相比,女性实现低密度脂蛋白(LDL)胆固醇<70mg/dl 目标的可能性更小(30.6%比 38.4%,p<0.001),实现非高密度脂蛋白胆固醇<100mg/dl 目标的可能性更小(37.1%比 48.2%,p<0.001)。无论年龄大小,女性实现 LDL 胆固醇目标的可能性均较小。与男性相比,女性更有可能未服用他汀类药物(16.9%比 11.6%,p<0.001)或任何降脂治疗(12.8%比 7.8%,p<0.001),而更有可能服用低强度他汀类药物(14.9%比 18.0%,p<0.001)或联合降脂治疗(22.2%比 30.1%,p<0.001)。冠心病患者中降脂治疗的使用存在显著的性别差异。总之,患有冠心病的女性接受的他汀类药物剂量不足,联合降脂治疗的应用也不足,且实现 LDL 和非高密度脂蛋白胆固醇最佳目标的可能性更小。