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TRIAD: Sex disparities present in cardiovascular disease mortality trends
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Differences in cardiovascular disease risk factor control and treatment between men and women were identified in the Translating Research Into Action for Diabetes (TRIAD) study.
Researchers performed cross-sectional analyses among a cohort of 1,315 women and 1,575 men with a history of CVD and 3,415 women and 2,516 men without a history of CVD.
Findings showed that women with diabetes and CVD were more likely to have poorer control of systolic BP (>140 mm Hg) and LDL cholesterol (>3.35 mmol/L) compared with men. Among these patients, 41.2% of men had uncontrolled systolic BP compared with 46.6% of women; 22.4% of men had uncontrolled LDL cholesterol compared with 28.3% of women. Women with both conditions were also less likely than men to receive intensive medication management when LDL cholesterol levels were uncontrolled.
The researchers found no significant differences in control of treatment in patients with diabetes and no CVD. – by Katie Kalvaitis
Diabetes Care. 2008;31:69-74.
There is some controversy about whether or not women and men have similar types of coronary artery disease. Some trials have suggested that if you treat women more like men they actually do better. The other possibility is that men are overtreated and women are not really undertreated. We all agree that the risk factors involved, such as hypertension and hypercholesterolemia, are the same for both men and women. So, the idea that we are undertreating women is problematic and the individuals who are being undertreated are those with known events. If confirmed, we as a community need to begin to look hard at our practices and make sure we deal with this issue. The researchers indicate some potential problems with their study design so confirmation in additional data sets would be advised. There have been reports of undertreatment in both minorities and women for a long time. The question is whether or not there are legitimate medical reasons for that and for this study it is hard to make an argument. If these findings are confirmed in other data sets, then we have some work to do in correcting this problem.
– Allan Jaffe, MD
Cardiovascular Division, Mayo Clinic, Rochester, Minn.