Leblay Lise, Lessard-Lord Jacob, Paquette Jean-Sébastien, Guénette Line, Drouin-Chartier Jean-Philippe
Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, Canada.
Faculté de Pharmacie, Université Laval, Québec, Canada.
Br J Nutr. 2025 Jan 16;133(3):1-11. doi: 10.1017/S0007114525000030.
Adherence to healthy diet principles and to cardiopreventive medication, both key behaviours in CVD prevention, is known to differ between women and men. Whether these adherence behaviours are differentially related among women and men has never been thoroughly assessed. The objective was to assess gender differences in the association between adherence to healthy diet principles and to cardiopreventive medication in adults free of CVD. This cross-sectional study included 268 women and 204 men from the CARTaGENE cohort (Québec, Canada) who were using antihypertensive and/or cholesterol-lowering medication. Adherence to healthy diet principles was assessed using the Alternate Healthy Eating Index (AHEI, %), calculated from a validated FFQ assessing diet in the 12-month preceding its completion. Medication adherence was assessed using the daily pharmacotherapy possession rate (DPPR, %), calculated from prescription claim data over the same 12-month period. In multivariable-adjusted analyses, an inverse association between AHEI and DPPR was observed among men ( for 10 % increment in DPPR = -0·65 %; 95 % CI -1·28 %, -0·03 %; = 0·04), while it tended to be positive among women ( = 0·44 %; 95 % CI -0·11 %, 1·00 %; = 0·12; = 0·01). The negative association between AHEI and DPPR was stronger among men who never smoked or used cholesterol-lowering medication only. Among women, the positive association was stronger and statistically significant among those with obesity or using ≥ 3 medications simultaneously. Association between adherence to healthy diet principles and to cardiopreventive medication differs between women and men, with men potentially facing greater challenges in achieving optimal complementarity between these two behaviours.
坚持健康饮食原则和坚持服用心血管预防药物是预防心血管疾病的两个关键行为，已知男女在这两方面存在差异。但这些坚持行为在男女之间的差异关系从未得到过全面评估。本研究的目的是评估无心血管疾病的成年人在坚持健康饮食原则和坚持服用心血管预防药物之间的关联中的性别差异。这项横断面研究纳入了来自加拿大魁北克CARTaGENE队列的268名女性和204名男性，他们正在服用抗高血压和/或降胆固醇药物。使用替代健康饮食指数（AHEI，%）评估对健康饮食原则的坚持情况，该指数根据一份经过验证的食物频率问卷（FFQ）计算得出，该问卷评估了在其完成前12个月的饮食情况。使用每日药物治疗持有率（DPPR，%）评估药物依从性，该指标根据同一12个月期间的处方报销数据计算得出。在多变量调整分析中，男性中观察到AHEI与DPPR之间存在负相关（DPPR每增加10% = -0.65%；95%置信区间为-1.28%，-0.03%；P = 0.04），而女性中则呈正相关趋势（P = 0.44%；95%置信区间为-0.11%，1.00%；P = 0.12；交互作用P = 0.01）。在从不吸烟或仅使用降胆固醇药物的男性中，AHEI与DPPR之间的负相关更强。在女性中，肥胖或同时使用≥3种药物的女性中，正相关更强且具有统计学意义。坚持健康饮食原则和坚持服用心血管预防药物之间的关联在男女之间存在差异，男性在实现这两种行为的最佳互补性方面可能面临更大挑战。
