Hyun Karice K, Redfern Julie, Patel Anushka, Peiris David, Brieger David, Sullivan David, Harris Mark, Usherwood Tim, MacMahon Stephen, Lyford Marilyn, Woodward Mark
The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.
Department of Cardiology, Concord Hospital, University of Sydney, Sydney, Australia.
Heart. 2017 Apr;103(7):492-498. doi: 10.1136/heartjnl-2016-310216. Epub 2017 Mar 1.
To quantify contemporary differences in cardiovascular disease (CVD) risk factor assessment and management between women and men in Australian primary healthcare services.
Records of routinely attending patients were sampled from 60 Australian primary healthcare services in 2012 for the Treatment of Cardiovascular Risk using Electronic Decision Support study. Multivariable logistic regression models were used to compare the rate of CVD risk factor assessment and recommended medication prescriptions, by gender.
Of 53 085 patients, 58% were female. Adjusting for demographic and clinical characteristics, women were less likely to have sufficient risk factors measured for CVD risk assessment (OR (95% CI): 0.88 (0.81 to 0.96)). Among 13 294 patients (47% women) in the CVD/high CVD risk subgroup, the adjusted odds of prescription of guideline-recommended medications were greater for women than men: 1.12 (1.01 to 1.23). However, there was heterogeneity by age (p <0.001), women in the CVD/high CVD risk subgroup aged 35-54 years were less likely to be prescribed the medications (0.63 (0.52 to 0.77)), and women in the CVD/high CVD risk subgroup aged ≥65 years were more likely to be prescribed the medications (1.34 (1.17 to 1.54)) than their male counterparts.
Women attending primary healthcare services in Australia were less likely than men to have risk factors measured and recorded such that absolute CVD risk can be assessed. For those with, or at high risk of, CVD, the prescription of appropriate preventive medications was more frequent in older women, but less frequent in younger women, compared with their male counterparts.
12611000478910, Pre-results.
量化澳大利亚初级医疗服务中男女在心血管疾病（CVD）风险因素评估与管理方面的当代差异。
2012年从澳大利亚60家初级医疗服务机构中抽取定期就诊患者的记录，用于心血管风险治疗电子决策支持研究。采用多变量逻辑回归模型按性别比较CVD风险因素评估率和推荐药物处方率。
在53085名患者中，58%为女性。在对人口统计学和临床特征进行调整后，女性进行CVD风险评估时测量到足够风险因素的可能性较小（比值比（95%置信区间）：0.88（0.81至0.96））。在CVD/高CVD风险亚组的13294名患者（47%为女性）中，女性开具指南推荐药物的调整后比值比高于男性：1.12（1.01至1.23）。然而，存在年龄异质性（p<0.001），35 - 54岁CVD/高CVD风险亚组的女性开具这些药物的可能性较小（0.63（0.52至0.77）），≥65岁CVD/高CVD风险亚组的女性开具这些药物的可能性高于男性同行（1.34（1.17至1.54））。
在澳大利亚初级医疗服务机构就诊的女性测量和记录风险因素以便评估绝对CVD风险的可能性低于男性。对于患有CVD或有CVD高风险的患者，与男性同行相比，老年女性更频繁地开具适当的预防性药物，而年轻女性则较少。
12611000478910，预结果。
