Oxford, UK—Disparities in cardiovascular-disease treatment appear to be continuing in the United States, with a new study demonstrating that women who experienced heart attacks were less likely than men to receive the high-intensity statins recommended to prevent further events.

The study, published in the Journal of the American College of Cardiology, points out that the gap continues despite evidence that more-intensive statins are effective for both sexes, and despite recent efforts to reduce sex differences in guideline-recommended treatment. It was conducted by The George Institute at Oxford University in conjunction with investigators from the University of Alabama at Birmingham.

Researchers used the MarketScan and Medicare databases to analyze data from 88,256 U.S. adults who filled a statin prescription within 30 days after hospital discharge for acute myocardial infarction (AMI) between January 2014 and June 2015. Results of the industry-funded study indicate that high-intensity doses were the first statin prescription filled following hospital discharge for 56% of men but only 47% of women.

Over time, the study team found that high-intensity statin prescription fills increased from 22% to 50% in women and from 27% to 60% in men. The disparity appeared to be unaffected by publication of the 2013 American College of Cardiology/American Heart Association cholesterol guideline recommending that all patients aged 75 years and younger who have experienced heart disease or stroke be treated with high-intensity statins based on clear evidence of their effectiveness and safety. 

“Prior studies have found that women are less likely than men to receive treatment with statins following a heart attack. Our study shows that even when women are prescribed statins, these continue to be in lower intensities than the guidelines recommend,” said lead researcher Sanne Peters, PhD, Research Fellow in Epidemiology at The George Institute. “The discrepancies in high-intensity statin use may explain, at least in part, why mortality rates for women with a history of heart disease and stroke are higher than for men. Our research suggests some deaths could be prevented if the guidelines on treatment with high-intensity statins were adhered to.”

Age or comorbidities did not have an effect on high-intensity statin prescription, according to Peters, but “the disparity was largest among the youngest and oldest adults and for those without other known health problems.”

Study authors posit that clinicians might perceive women who have experienced a heart attack to be at lower risk for recurrence than similarly situated men. Previous research has suggested that clinicians often believe that women have a lower perceived heart disease risk.
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