The online version of this article (doi:10.1186/1758-5996-6-117) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
AML, SHS, KB, NAK, LP, JAJ, WAG, DMR made substantial contributions to the conception and design of the study. AML, SHS, DMR acquired the data and AML performed the analysis. SB, AML, SHS, KB, NAK, LP, JAJ, WAG, DMR contributed to the interpretation of data. SB, AML, DMR drafted the manuscript and SB, AML, SHS, KB, NAK, LP, JAJ, WAG, DMR contributed to the discussion and reviewed/edited the manuscript. All authors gave final approval of the version to be published.
The identification of sex-based disparities in the use of effective medications in high-risk populations can lead to interventions to minimize disparities in health outcomes. The objective of this study was to determine sex-specific rates of cardioprotective medication use in a large population-level administrative-health database from a universal-payer environment.
This observational, population-based cohort study used provincial administrative data to compare the utilization of cardioprotective medications between women and men in the first year following a diabetes diagnosis. Competing risks regression was used to calculate crude and adjusted sub-hazard ratios for time-to-first angiotensin-converting-enzyme inhibitor, angiotensin receptor blocker, or statin dispensations.
There were 15,120 (45.4%) women and 18,174 (54.6%) men with diabetes in the study cohort. Overall cardioprotective medication use was low for both primary and secondary prevention for both women and men. In the year following a diabetes diagnosis, women were less likely to use a statin relative to men (adjusted sub-hazard ratio [aSHR] 0.90, 95% confidence interval [CI] 0.85 to 0.96), angiotensin-converting-enzyme inhibitors (aSHR 0.90, 95% CI 0.86 to 0.94), or any cardioprotective medication (aSHR 0.93, 95% CI 0.90 to 0.97).
Cardioprotective medication use was not optimal in women or men. We also identified a health care gap with cardioprotective medication use being lower in women with diabetes compared to men. Closing this gap has the potential to reduce the impact of cardiovascular disease in women with diabetes.
Additional file 1: Appendix 1: Diagnostic codes for cardiovascular diseases using the International Statistical Classification of Diseases and Related Health Problem (ICD), Ninth or Tenth Revision and procedure codes for percutaneous coronary intervention or coronary artery bypass grafting surgery using the Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures (CCP) or Canadian Classification of Health Interventions (CCI). Appendix 2. STROBE Checklist. (Modified from https://www.strobe-statement.org/index.php?id=available-checklists). (DOC 98 KB)
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- Sex-based disparities in cardioprotective medication use in adults with diabetes
Adriane M Lewin
Scot H Simpson
Jeffrey A Johnson
William A Ghali
Doreen M Rabi
- BioMed Central
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