scholarly journals Gender Differences in the Risk of Ischemic Heart Disease According to Healthcare Utilization and Medication Adherence among Newly Treated Korean Hypertensive Patients

Author(s):  
Jiae Shin ◽  
Dongwoo Ham ◽  
Hee Young Paik ◽  
Sangah Shin ◽  
Hyojee Joung

We aimed to investigate gender differences in ischemic heart disease (IHD) according to healthcare utilization and medication adherence among newly treated Korean hypertensive adults. The National Sample Cohort version 2.0 of the National Health Insurance Service was used for analysis. Newly treated hypertensive patients ≥ 20 years and without IHD in 2002 were selected from a population that underwent health examination during 2003–2006. Of those patients, 11,942 men and 11,193 women were analyzed and followed up for 10 years. We determined the association between IHD and healthcare utilization and medication adherence using the Cox proportional hazards model. Hypertensive women patients had a lower risk of IHD than men patients (hazard ratio [HR] = 0.93, 95% confidence interval [CI] 0.88–1.00). The IHD risk was increased in patients who visited healthcare providers > 12 times/person-year (HR = 2.97, 95% CI 2.79–3.17), paid high out-of-pocket expense/person-year (HR = 1.55, 95% CI 1.41–1.69), and had medication nonadherence (HR = 1.67, 95% CI 1.58–1.77). However, the risk was decreased in patients who used both urban and rural areas (HR 0.75, 95% CI 0.67–0.84) and mixed types of providers (HR = 0.93, CI 0.88–0.99). The risk of IHD was significantly different between men and women only in the visiting frequency to healthcare providers (men, HR = 3.21, 95% CI 2.93–3.52; women, HR = 2.78, 95% CI 2.53–3.04, p for interaction = 0.0188). In summary, the risk of IHD was similar according to healthcare utilization and medication adherence between men and women, except visiting frequency to healthcare providers.

2011 ◽  
Vol 19 (6) ◽  
pp. 1462-1469 ◽  
Author(s):  
David Sancho Cantus ◽  
María del Carmen Solano Ruiz

Nowadays, Coronary Diseases (CDs) represent the main mortality cause in men and women, but there are gender differences regarding their presentation, progression and the way the disease is tackled. This study mainly focuses on reviewing literature about the CD and its gender approach. The authors carried out a search of texts that use qualitative methodology, published between 2003 and 2009 in the following databases: PUBMED, IME, CUIDEN and CINAHL. Factors that hinder the early diagnosis of Ischemic Heart Disease in women are identified as the main findings, and the possible consequences are pointed out. In the fifty-six texts that were selected initially, we can see the difficulty women face to recognize early symptoms of the CD and their low risk perception of this disease. Greater awareness on Ischemic Heart Disease is needed, so that the high morbidity and mortality rates can be reduced.


2020 ◽  
Vol 26 ◽  
Author(s):  
Maria Bergami ◽  
Marialuisa Scarpone ◽  
Edina Cenko ◽  
Elisa Varotti ◽  
Peter Louis Amaduzzi ◽  
...  

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.


Stroke ◽  
2021 ◽  
Author(s):  
Satoyo Ikehara ◽  
Hiroyasu Iso ◽  
Yoshihiro Kokubo ◽  
Kazumasa Yamagishi ◽  
Isao Saito ◽  
...  

Background and Purpose: Several prospective cohort studies and a randomized clinical trial have shown the beneficial effects of peanut consumption on cardiovascular disease and its risk factors. We examined the association between peanut consumption and risk of cardiovascular disease in Japanese men and women. Methods: We analyzed data of 74 793 participants aged 45 to 74 years who completed a lifestyle questionnaire including the validated food frequency questionnaire in the Japan Public Health Center–based Prospective Study. They were followed up from 1995 to 2009 for cohort I and from 1998 to 1999 to 2012 for cohort II. Peanut consumption was calculated from the food frequency questionnaire, and the end points were incidence of stroke, ischemic heart disease, and cardiovascular disease (stroke and ischemic heart disease). Results: During a median follow-up of 14.8 years, 3,599 strokes and 849 ischemic heart diseases were reported. Higher peanut consumption was associated with reduced risks of total stroke, ischemic stroke, and cardiovascular disease among men and women. The multivariable hazard ratios (95% CIs) for the highest versus lowest quartiles of peanut consumption after adjustment for age, sex, public health center, smoking, alcohol consumption, perceived stress level, physical activity, vegetable, fruit, fish, soy, sodium and total energy intakes, body mass index, history of hypertension, history of diabetes, and cholesterol-lowering drug were 0.84 (0.77–0.93, P for trend=0.002) for total stroke, 0.80 (0.71–0.90, P for trend=0.002) for ischemic stroke, 0.93 (0.79–1.08, P for trend=0.27) for hemorrhagic stroke, 0.97 (0.80–1.17, P for trend=0.81) for ischemic heart disease and 0.87 (0.80–0.94, P for trend=0.004) for cardiovascular disease, and these associations were similarly observed in both sexes. Conclusions: Higher peanut consumption was associated with reduced risk of stroke, especially ischemic stroke, but not ischemic heart disease in Japanese men and women.


Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 392 ◽  
Author(s):  
Liucija Černiauskienė ◽  
Dalia Lukšienė ◽  
Abdonas Tamošiūnas ◽  
Regina Rėklaitienė ◽  
Lilija Margevičienė

The aim of this study was to evaluate the association of metabolic syndrome and oxidative stress with ischemic heart disease in middle-aged persons (men and women aged 45–64 years). Material and methods. In this study, we have used data of 533 persons (247 men and 286 women) aged 45– 64 years from Kaunas population cohort investigated according to WHO MONICA study protocol during 2001–2002 in whom concentrations of malondialdehyde, a marker of lipid peroxidation, and antioxidant vitamin E in blood serum were determined. Metabolic syndrome was defined by the criteria of Adult Treatment Panel III. Oxidative stress was determined in the presence of increased level of malondialdehyde (≥5 mmol/L) and decreased level of lipid-standardized vitamin E (<20 mmol/L). The levels of malondialdehyde and vitamin E were measured by fluorimetric methods. Results. Ischemic heart disease was diagnosed in 19.8% of men and 21.3% of women. The frequency of ischemic heart disease among persons (men and women) with metabolic syndrome was significantly higher than among persons without metabolic syndrome (27.4% vs. 17.8%, respectively; odds ratio, 1.63; P=0.032). The frequency of ischemic heart disease among persons with oxidative stress was significantly higher than among persons without oxidative stress (29.1% vs. 17.6%, respectively; odds ratio, 1.88; P=0.029). The highest prevalence of ischemic heart disease (30.0%) was among persons with metabolic syndrome and oxidative stress, and the lowest prevalence of this disease (13.8%) was among persons without metabolic syndrome and without oxidative stress (odds ratio, 2.54; P=0.017). These data were adjusted by sex and age. Conclusion. Metabolic syndrome and oxidative stress are significantly associated with ischemic heart disease among 45–64-year-old persons.


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