Gender disparities in the pharmacological treatment of cardiovascular disease and diabetes mellitus in the very old: an epidemiological, cross-sectional survey

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Brännström, JonUmeå universitet,Geriatrik (författare)

Gender disparities in the pharmacological treatment of cardiovascular disease and diabetes mellitus in the very old : an epidemiological, cross-sectional survey

Artikel/kapitelEngelska2011

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Springer Science and Business Media LLC,2011
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LIBRIS-ID:oai:DiVA.org:umu-52740
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-52740URI
https://doi.org/10.2165/11594730-000000000-00000DOI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:art swepub-publicationtype

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BACKGROUND: There are many reports of disparities in health and medical care both between women and men and between various age groups. In most cases, men receive better treatment than women and young and middle-aged people are privileged compared with the old and the very old. Cardiovascular morbidity and diabetes mellitus are common, increase with age and are often treated extensively with drugs, many of which are known to have significant adverse effects.OBJECTIVE: The aim of the study was to analyse gender differences in the pharmacological treatment of cardiovascular disease and diabetes among very old people.METHODS: The study took the form of an epidemiological, cross-sectional survey. A structured interview was administered during one or more home visits, and data were further retrieved from medical charts and interviews with relatives, healthcare staff and other carers. Home-dwelling people as well as people living in institutional care in six municipalities in the county of Västerbotten, Sweden, in 2005-7 were included in the study. Half of all people aged 85 years, all of those aged 90 years and all of those aged ≥95 years living in the selected municipalities were selected for inclusion in the study. In total, 467 people were included in the present analysis. The main study outcome measures were medical diagnoses and drug use.RESULTS: In total, women were prescribed a larger number of drugs than men (mean 7.2 vs 5.4, p < 0.001). Multiple logistic regression models adjusted for age and other background variables as well as relevant medical diagnoses (hypertension, heart failure) showed strong associations between female sex and prescriptions of thiazide diuretics (odds ratio [OR] 4.4; 95% CI 1.8, 10.8; p = 0.001), potassium-sparing diuretics (OR 3.5; 95% CI 1.4, 8.7; p = 0.006) and diuretics as a whole (OR 1.8; 95% CI 1.1, 2.9; p = 0.021). A similar model, adjusted for angina pectoris, showed that female sex was associated with prescription of short-acting nitroglycerin (OR 3.7; 95% CI 1.6, 8.9; p = 0.003). However, more men had been offered coronary artery surgery (p = 0.001). Of the participants diagnosed with diabetes, 55% of the women and 85% of the men used oral antihyperglycaemic drugs (p = 0.020), whereas no gender difference was seen in prescriptions of insulin.CONCLUSIONS: Significant gender disparities in the prescription of several drugs, such as diuretics, nitroglycerin and oral antihyperglycaemic drugs, were observed in this study of very old people. In most cases, women were prescribed more drugs than men. Men more often had undergone coronary artery surgery. These disparities could only in part be explained by differences in diagnoses and symptoms.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Geriatrik hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Geriatrics hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Annan medicin och hälsovetenskap Gerontologi, medicinsk/hälsovetenskaplig inriktning hsv//swe
MEDICAL AND HEALTH SCIENCES Other Medical and Health Sciences Gerontology, specialising in Medical and Health Sciences hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Farmakologi och toxikologi hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Pharmacology and Toxicology hsv//eng
Antihyperglycaemics; Cardiovascular-disorders; Diabetes-mellitus
diuretics
drug-utilisation
elderly
nitroglycerin
sex-differences

Biuppslag (personer, institutioner, konferenser, titlar ...)

Hamberg, KatarinaUmeå universitet,Allmänmedicin(Swepub:umu)kaha0002 (författare)
Molander, LenaUmeå universitet,Geriatrik(Swepub:umu)leamor01 (författare)
Lövheim, HugoUmeå universitet,Geriatrik(Swepub:umu)huolom01 (författare)
Gustafson, YngveUmeå universitet,Geriatrik(Swepub:umu)yngu0001 (författare)
Umeå universitetGeriatrik (creator_code:org_t)

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Ingår i:Drugs & Aging: Springer Science and Business Media LLC28:12, s. 993-10051170-229X1179-1969

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Av författaren/redakt...: Brännström, Jon; Hamberg, Katarin ...; Molander, Lena; Lövheim, Hugo; Gustafson, Yngve

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