Abstract 15804: Gender-Specific Analysis of Current Trends in Primary Prevention of ASCVD

Abstract

Introduction: Cardiovascular disease is the leading cause of death in the U.S. for both men and women. Disparities exist not only in women’s outcomes from atherosclerotic cardiovascular disease (ASCVD) but also in assessment of their risk of disease development. This can be attributed in part to the historical misperception that ASCVD affects males at a greater rate than females. This study examines whether female patients are appropriately prescribed statin medication for primary prevention of ASCVD at the same rates as male patients of equivalent risk. Methods: Data were gathered from 11,871 de-identified UC San Diego patient medical records, which included primary care patients ages 40 to 75 without prior ASCVD. The ACC/AHA 10-Year ASCVD Risk Estimator was used to calculate risk scores. The groups of elevated-risk patients, defined by a score greater than or equal to 7.5, of each gender who were and were not prescribed statins were compared using a Chi-Square analysis, conducted in SPSS, in order to determine whether a significant difference existed in appropriate statin prescription between male and female patients. Significance was assessed using the Pearson Chi-Square value compared to a 0.05 significance threshold. Results: In the group of male patients, 796 were on a statin when indicated, compared to the expected value of 803.1, and 807 were not, compared to 789.9 expected. For the female group, 305 patients were on a statin when indicated, compared to 287.9 expected, and 266 were not, compared to 283.1 expected. The Pearson Chi-Square value comparing the groups was 0.095, which is greater than the 0.05 significance threshold. Conclusions: Because of evidence that physicians may be influenced by biases about women’s heart disease risk, this study assessed the hypothesis that there would be a significant difference in appropriate prescription of statins for primary ASCVD prevention between male and female patients. This analysis did not show evidence of a statistically significant difference between the rates of untreated elevated-risk men versus women in this patient population. Though a single-institution study, these findings may signal increasing awareness of women's heart disease risk among primary care physicians.