This article is more than 5 years old. Information may no longer be current.

Male PCPs should be aware of potential gender bias in CHD prevention

Women receive less satisfactory preventive management than men do, even before the onset of cardiovascular disease, especially if their physician is a man, according to data published in the European Journal of Preventive Cardiology.

The researchers concluded that primary care physicians need to pay attention to the influence of gender stereotypes, and how they may affect their judgement. They also stated that more attention to gender stereotypes is needed in medical training.

“The first stage of cardiovascular disease prevention for any patient is an assessment of his or her risk based on different risk factors,” Raphaëlle Delpech, MD, of the department of general practice at Paris-Sud University, in France, and colleagues wrote. “The first stage of the primary prevention of cardiovascular disease is thus an assessment of the patient’s risk, based on various risk factors. At this initial stage, it may be that prevention is practiced differentially according to the patient’s gender, as it is for secondary prevention (ie, less often for women). Moreover, primary prevention is performed primarily by general practitioners (GPs) or family practitioners, and their preventive practices vary according to gender.”

To analyze cardiovascular risk assessment of patients for primary prevention among GPs, with particular attention paid to the gender of both the physician and the patient, the researchers conducted an observational survey of 52 GPs who were internship supervisors in the Paris metropolitan area. They completed a self-administered questionnaire covering their own characteristics and randomly selected 70 patients from their patient list.

Dependent variables from the patient files included the presence of information about risk factors necessary to assess the patient’s cardiovascular risk in terms of the French scale and the Systematic Coronary Risk Evaluation (SCORE) scale. The researchers used mixed logistic models with a random intercept, and adjusted for patient and physician characteristics.

According to the researchers, both cardiovascular risk scales could be assessed less frequently in women than in men (OR = 0.64; 95% CI, 0.5-0.8, for the French scale, and OR = 0.63; 95% CI, 0.5-0.8, for the SCORE scale). The differences between the genders were less substantial when the patients were seen by a female GP (OR = 0.72; 95% CI, 0.5-1.01 for the SCORE scale), compared with male physicians (OR = 0.56; CI 95%, 0.4-0.7). Patients who were least well assessed for cardiovascular risk were women seen by male GPs.

“Our study shows that even before the onset of a cardiovascular disease, women patients receive less satisfactory preventive management than men do, as already shown at subsequent stages of cardiovascular risk management (at the moment of a cardiovascular event or for secondary prevention),” Delpech and colleagues wrote. “Nonetheless, it appears that these differences are still more marked when the physician is a man. Although the increasing percentage of women doctors will have a favorable impact on these gender differences, doctors need to be more aware that their own personal characteristics (and not only those of their patients) influence their practices.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.