In preterm ASCVD, women report poorer mental, physical health than men

07 January 2022

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disclosures: Jain reports no relevant financial disclosures. See the study for the relevant financial disclosures from all other authors.

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Among patients with premature atherosclerotic CVD, women were more likely to report poor mental and physical health than men, according to data published in JAMA Cardiology.

The researchers analyzed 28,522 patients ages 18 to 55 (47% women) with self-reported premature ASCVD (CAD, MI, or stroke) who were included in the Behavioral Risk Factor Surveillance System from 2016 to 2019.

Graphical representation of data presented in article
Data are derived from Jain V, et al. JAMA Cardio, 2022; doi:10.1001/jamacardio.2021.5430.

Compared to men with preterm ASCVD, women with preterm ASCVD reported more likely to be clinically depressed (OR = 1.73; 95% CI, 1.41-2.14; p < 0.001) and have overall poor physical health (OR = 1.39; 95% CI 1.09-1.78; p = .008), Vardhman Jain, MD, internal medicine resident at Cleveland Clinic, and colleagues wrote.

Women were also more likely than men to report having cost-related non-compliance (OR = 1.42; 95% CI, 1.11-1.82; p = 0.005) and did not see a physician due to cost-related issues (OR = 4.52; 95% CI, 2.24-9.13; p < .001), the researchers said.

However, Jain and colleagues found that women were more likely than men to have health coverage (85.3% vs. 80.8%; p = .04) and have a GP (84.2% vs. 75.7%; p < .001).

Sensitivity analyzes by race, ethnicity and very premature ASCVD did not alter the results.

“These findings suggest that while women are more likely to seek routine care, they may face barriers to accessing this care,” Jain and colleagues wrote. “We found that despite having a primary care physician and health care coverage, women were more likely to have cost-related barriers to accessing health care. Women were also more likely to report lower incomes and were below the federal poverty line. So despite the fact that they have health care coverage, it may be more difficult for women to see a doctor or take a prescription drug compared to men because of co-payments or other costs.With the emergence of new therapies, the cost of medication is expected to rise , which can exacerbate unaddressed differences. Furthermore, it has been shown that women are more likely to be dissatisfied with the health care system in a setting of poor communication between patient and doctor, which can further discourage them from going to their doctor.”

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