Goldstein Karen M, Stechuchak Karen M, Zullig Leah L, Oddone Eugene Z, Olsen Maren K, McCant Felicia A, Bastian Lori A, Batch Bryan C, Bosworth Hayden B
1 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.
2 Division of General Internal Medicine, Department of Medicine, Duke University Medical Center , Durham, North Carolina.
J Womens Health (Larchmt). 2017 Jul;26(7):806-814. doi: 10.1089/jwh.2016.5739. Epub 2017 Feb 13.
Compared with men, women have poorer lipid control. Although potential causes of this disparity have been explored, it is unknown whether patient-centered factors such as satisfaction and confidence contribute. We evaluated (1) whether satisfaction with lipid control and confidence in ability to improve it vary by gender and (2) whether sociodemographic characteristics modify the association.
We evaluated baseline survey responses from the Cardiovascular Intervention Improvement Telemedicine Study, including self-rated satisfaction with cholesterol levels and confidence in controlling cholesterol. Participants had poorly controlled hypertension and/or hypercholesterolemia.
A total of 428 veterans (15% women) participated. Compared with men, women had higher low-density lipoprotein values at 141.2 versus 121.7 mg/dL, respectively (p < 0.05), higher health literacy, and were less likely to have someone to help track their medications (all p < 0.05). In an adjusted model, women were less satisfied with their cholesterol levels than men with estimated mean scores of 4.3 versus 5.6 on a 1-10 Likert scale (p < 0.05). There was no significant difference in confidence by gender. Participants with support for tracking medications reported higher confidence levels than those without, estimated mean 7.8 versus 7.2 (p < 0.05).
Women veterans at high risk for cardiovascular disease were less satisfied with their lipid control than men; however, confidence in ability to improve lipid levels was similar. Veterans without someone to help to track medications were less confident, and women were less likely to have this type of social support. Lack of social support for medication tracking may be a factor in lingering gender-based disparities in hyperlipidemia.
与男性相比，女性的血脂控制情况较差。尽管已经探讨了这种差异的潜在原因，但尚不清楚以患者为中心的因素，如满意度和信心是否起作用。我们评估了（1）血脂控制的满意度和改善血脂能力的信心是否因性别而异，以及（2）社会人口学特征是否会改变这种关联。
我们评估了心血管介入改善远程医疗研究的基线调查回复，包括对胆固醇水平的自评满意度和控制胆固醇的信心。参与者患有控制不佳的高血压和/或高胆固醇血症。
共有428名退伍军人（15%为女性）参与。与男性相比，女性的低密度脂蛋白值更高，分别为141.2mg/dL和121.7mg/dL（p<0.05），健康素养更高，且不太可能有人帮助她们追踪药物治疗情况（所有p<0.05）。在一个校正模型中，女性对其胆固醇水平的满意度低于男性，在1-10李克特量表上的估计平均得分分别为4.3和5.6（p<0.05）。性别之间的信心没有显著差异。有药物追踪支持的参与者报告的信心水平高于没有支持的参与者，估计平均分为7.8和7.2（p<0.05）。
心血管疾病高危的女性退伍军人对血脂控制的满意度低于男性；然而，改善血脂水平的信心相似。没有他人帮助追踪药物治疗的退伍军人信心较低，且女性获得这种社会支持的可能性较小。缺乏药物追踪的社会支持可能是高脂血症中持续存在的性别差异的一个因素。
