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Evidence for an age and gender bias in the secondary prevention of ischaemic heart disease in primary care
Author(s) -
Williams David,
Bennett Kathleen,
Feely John
Publication year - 2003
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1046/j.1365-2125.2003.01795.x
Subject(s) - medicine , aspirin , medical prescription , odds ratio , confidence interval , myocardial infarction , population , pharmacology , environmental health
Aims To determine if a gender or age bias exists in the prescription of important secondary preventive therapies for ischaemic heart disease in primary care. Methods We identified 15 590 patients with ischaemic heart disease on the basis that they received a prescription for nitrate therapy over a 1‐year period (September 1999 to August 2000) from the Eastern Region of the General Medical Services scheme in Ireland (population of 334 031), which provides free health service to those eligible patients in primary care. Odds ratios (OR) for the prescription of aspirin, β‐blockers, statins, calcium channel antagonists and ACE inhibitors in women and in those aged> 65 years were determined. Results Female patients were less likely to receive a prescription for a β‐blocker [OR = 0.84, 95% confidence interval (CI) = 0.79, 0.89, P < 0.001], aspirin (OR = 0.72, 95% CI = 0.67, 0.78, P < 0.001), and ACE inhibitors (OR = 0.83, 95% CI = 0.78, 0.89, P < 0.001) compared with their male counterparts. However, women were more likely to receive anxiolytic benzodiazepines (OR = 1.71, 95% CI = 1.59, 1.85, P < 0.001) compared with their male counterparts. Elderly patients (aged> 65 years) were less likely to receive aspirin (OR = 0.92, 95% CI = 0.85, 0.99, P < 0.001), β‐blocker (OR = 0.66, 95% CI = 0.62, 0.71, P < 0.001) and a statin (OR = 0.5, 95% CI = 0.46, 0.53, P < 0.001). Conclusions An age and gender bias exists in the prescription of important secondary preventive therapies in primary care that may lead to increased mortality from ischaemic heart disease in these groups.