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01.12.2014 | Research | Ausgabe 1/2014 Open Access

Diabetology & Metabolic Syndrome 1/2014

Sex-based disparities in cardioprotective medication use in adults with diabetes

Zeitschrift:
Diabetology & Metabolic Syndrome > Ausgabe 1/2014
Autoren:
Sonia Butalia, Adriane M Lewin, Scot H Simpson, Kaberi Dasgupta, Nadia Khan, Louise Pilote, Jeffrey A Johnson, William A Ghali, Doreen M Rabi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1758-5996-6-117) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

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.

Abstract

Objective

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.

Research design and methods

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.

Results

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).

Conclusions

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.
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