National Centre for Healthcare Research and Pharmacoepidemiology Department of Statistics and Quantitative Methods, University of Milano-Bicocca Epidemiologic Observatory, Lombardy Regional Health Service University of Milano-Bicocca, Milan Policlinico di Monza, Monza, Italy.
J Hypertens. 2020 Jan;38(1):142-149. doi: 10.1097/HJH.0000000000002222.
Several factors affect adherence to antihypertensive drug treatment, but whether these factors include a sex difference is unclear. Aim of the study was to compare persistence with antihypertensive drug therapy between men and women in a large cohort of patients.
The 60 526 residents of the Italian Lombardy Region aged 40-80 years newly treated with antihypertensive drugs during 2010 were identified and followed for 1 year after the first prescription. Discontinuation of treatment was defined as lack of prescription renewal for at least 90 days. Log-binomial regression models were fitted to estimate the risk ratio of treatment discontinuation in relation to sex. Other than for the whole population, analyses were stratified according to age, comorbidity status and the initial antihypertensive treatment strategy.
Thirty-seven percent of the patients discontinued the drug treatment during follow-up. Compared with women, men had a 10% lower risk of discontinuation of drug treatment (95% confidence interval: 8-12). Persistence on antihypertensive treatment was better in men than in women, this being the case in both younger (40-64 years) and older patients (65-80 years), in patients starting treatment with any major antihypertensive drug and in patients who had a low comorbidity status. There was no evidence that men and women had a different risk of treatment discontinuation when their comorbidity status was worse, or initial antihypertensive treatment was based on drug combinations.
Our data show that in a real-life setting, men are more persistent to antihypertensive drug therapy than women.
有几个因素会影响抗高血压药物治疗的依从性，但这些因素是否包括性别差异尚不清楚。本研究的目的是在一个大型患者队列中比较男性和女性对降压药物治疗的坚持情况。
在意大利伦巴第地区，2010 年新接受抗高血压药物治疗的年龄在 40-80 岁的 60526 名居民被确定，并在首次处方后随访 1 年。停药定义为至少 90 天未续开处方。使用对数二项式回归模型来估计与性别相关的停药风险比。除了全人群外，还根据年龄、合并症状况和初始降压治疗策略进行了分层分析。
37%的患者在随访期间停止了药物治疗。与女性相比，男性停药的风险降低了 10%（95%置信区间：8-12）。男性的降压治疗持续率优于女性，这种情况在年轻（40-64 岁）和老年（65-80 岁）患者、开始使用任何主要降压药物治疗的患者以及合并症状况较低的患者中均存在。当患者的合并症状况更差或初始降压治疗基于药物联合治疗时，没有证据表明男性和女性停药的风险存在差异。
我们的数据表明，在现实环境中，男性比女性更坚持抗高血压药物治疗。
