In premature ASCVD, women report worse mental, physical health vs. men
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Among patients with premature atherosclerotic CVD, women were more likely to report poor mental and physical health than men, according to data published in JAMA Cardiology.
The researchers analyzed 28,522 patients aged 18 to 55 years (47% women) with self-reported premature ASCVD (CAD, MI or stroke) who were included in the Behavioral Risk Factor Surveillance System from 2016 to 2019.
Compared with men with premature ASCVD, women with premature ASCVD were more likely to report being clinically depressed (OR = 1.73; 95% CI, 1.41-2.14; P < .001) and having overall poor physical health (OR = 1.39; 95% CI, 1.09-1.78; P = .008), Vardhmaan Jain, MD, internal medicine resident at Cleveland Clinic, and colleagues wrote.
Women were also more likely than men to report having cost-related medication nonadherence (OR = 1.42; 95% CI, 1.11-1.82; P = .005) and having not seen a physician due to cost-related issues (OR = 4.52; 95% CI, 2.24-9.13; P < .001), according to the researchers.
However, Jain and colleagues found, women were more likely than men to have health care coverage (85.3% vs. 80.8%; P = .04) and to have a primary care physician (84.2% vs. 75.7%; P < .001).
Sensitivity analyses by race, ethnicity and very premature ASCVD did not change the results.
“These findings suggest that while women might be more likely to seek routine care, they may face barriers to accessing this care,” Jain and colleagues wrote. “We found that despite having a primary care physician and health care coverage, women were more likely to have cost-related barriers to health care access. Women were also more likely to report lower income and to be below the federal poverty line. Thus, despite having health care coverage, it may be more difficult for women to see a clinician or take a prescribed medication compared with men because of copays or other expenses. With new therapies emerging, the cost of medication is expected to increase, which may worsen unaddressed disparities. Further, women have been shown to have higher rates of dissatisfaction with the health care system in the setting of poor patient-physician communication, which may discourage them further from seeing their physicians.”
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