Evidence for Age and Sex Differences in the Secondary Prevention of Stroke in Scottish Primary Care

Colin Richard Simpson, C. Wilson, Philip Christopher Hannaford, David Williams

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Background and Purpose - Secondary preventive measures play an important role in the reduction of stroke, the third largest cause of death in Scotland. We investigated whether sex, age, or deprivation differences existed in the secondary prevention of stroke in primary care.

Methods - A retrospective cross-sectional study using a computerized database with 61 practices ( 377 439 patients) to identify group differences in secondary preventive therapy between March 2003 and April 2004 for 10 076 patients with a diagnosis of any stroke.

Results - Women with any stroke were more likely than men to be prescribed a thiazide ( odds ratios [ OR], 1.60; 95% confidence interval [CI], 1.46 to 1.75) but less likely to be prescribed an angiotensin-converting enzyme inhibitor ( OR, 0.73; 95% CI, 0.67 to 0.81). Women with ischemic stroke were less likely to receive either an antiplatelet or warfarin ( OR, 0.84; 95% CI, 0.75 to 0.94) or statin therapy ( OR, 0.82; 95% CI, 0.74 to 0.90) than men. Women with atrial fibrillation received less warfarin ( OR, 0.62; 95% CI, 0.48 to 0.81) but more antiplatelet therapy than men ( OR, 1.30; 95% CI, 1.00 to 1.68). The oldest patients ( older than 75 years) with ischemic stroke received more antiplatelet therapy than the youngest patients ( younger than 65 years) ( OR, 1.83; 95% CI, 1.64 to 2.06). No significant differences in secondary preventative treatment across deprivation groups were found.

Conclusion - Important sex and age differences exist in the care of patients with stroke and suggest that women and the elderly need to be targeted for secondary prevention therapy.

Original languageEnglish
Pages (from-to)1771-1775
Number of pages4
JournalStroke
Volume36
DOIs
Publication statusPublished - 2005

Keywords

  • age
  • anticoagulation
  • antihypertensive agents
  • antiplatelet drugs
  • database
  • epidemiology
  • prevention
  • sex
  • stroke management
  • GENERAL-PRACTICE
  • ATRIAL-FIBRILLATION
  • CONTROLLED TRIAL
  • BLOOD-PRESSURE
  • HEART-DISEASE
  • MANAGEMENT
  • RISK
  • INDIVIDUALS
  • MORBIDITY
  • INEQUALITIES

Cite this

Evidence for Age and Sex Differences in the Secondary Prevention of Stroke in Scottish Primary Care. / Simpson, Colin Richard; Wilson, C.; Hannaford, Philip Christopher; Williams, David.

In: Stroke, Vol. 36, 2005, p. 1771-1775.

Research output: Contribution to journalArticle

Simpson, Colin Richard ; Wilson, C. ; Hannaford, Philip Christopher ; Williams, David. / Evidence for Age and Sex Differences in the Secondary Prevention of Stroke in Scottish Primary Care. In: Stroke. 2005 ; Vol. 36. pp. 1771-1775.
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T1 - Evidence for Age and Sex Differences in the Secondary Prevention of Stroke in Scottish Primary Care

AU - Simpson, Colin Richard

AU - Wilson, C.

AU - Hannaford, Philip Christopher

AU - Williams, David

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N2 - Background and Purpose - Secondary preventive measures play an important role in the reduction of stroke, the third largest cause of death in Scotland. We investigated whether sex, age, or deprivation differences existed in the secondary prevention of stroke in primary care.Methods - A retrospective cross-sectional study using a computerized database with 61 practices ( 377 439 patients) to identify group differences in secondary preventive therapy between March 2003 and April 2004 for 10 076 patients with a diagnosis of any stroke.Results - Women with any stroke were more likely than men to be prescribed a thiazide ( odds ratios [ OR], 1.60; 95% confidence interval [CI], 1.46 to 1.75) but less likely to be prescribed an angiotensin-converting enzyme inhibitor ( OR, 0.73; 95% CI, 0.67 to 0.81). Women with ischemic stroke were less likely to receive either an antiplatelet or warfarin ( OR, 0.84; 95% CI, 0.75 to 0.94) or statin therapy ( OR, 0.82; 95% CI, 0.74 to 0.90) than men. Women with atrial fibrillation received less warfarin ( OR, 0.62; 95% CI, 0.48 to 0.81) but more antiplatelet therapy than men ( OR, 1.30; 95% CI, 1.00 to 1.68). The oldest patients ( older than 75 years) with ischemic stroke received more antiplatelet therapy than the youngest patients ( younger than 65 years) ( OR, 1.83; 95% CI, 1.64 to 2.06). No significant differences in secondary preventative treatment across deprivation groups were found.Conclusion - Important sex and age differences exist in the care of patients with stroke and suggest that women and the elderly need to be targeted for secondary prevention therapy.

AB - Background and Purpose - Secondary preventive measures play an important role in the reduction of stroke, the third largest cause of death in Scotland. We investigated whether sex, age, or deprivation differences existed in the secondary prevention of stroke in primary care.Methods - A retrospective cross-sectional study using a computerized database with 61 practices ( 377 439 patients) to identify group differences in secondary preventive therapy between March 2003 and April 2004 for 10 076 patients with a diagnosis of any stroke.Results - Women with any stroke were more likely than men to be prescribed a thiazide ( odds ratios [ OR], 1.60; 95% confidence interval [CI], 1.46 to 1.75) but less likely to be prescribed an angiotensin-converting enzyme inhibitor ( OR, 0.73; 95% CI, 0.67 to 0.81). Women with ischemic stroke were less likely to receive either an antiplatelet or warfarin ( OR, 0.84; 95% CI, 0.75 to 0.94) or statin therapy ( OR, 0.82; 95% CI, 0.74 to 0.90) than men. Women with atrial fibrillation received less warfarin ( OR, 0.62; 95% CI, 0.48 to 0.81) but more antiplatelet therapy than men ( OR, 1.30; 95% CI, 1.00 to 1.68). The oldest patients ( older than 75 years) with ischemic stroke received more antiplatelet therapy than the youngest patients ( younger than 65 years) ( OR, 1.83; 95% CI, 1.64 to 2.06). No significant differences in secondary preventative treatment across deprivation groups were found.Conclusion - Important sex and age differences exist in the care of patients with stroke and suggest that women and the elderly need to be targeted for secondary prevention therapy.

KW - age

KW - anticoagulation

KW - antihypertensive agents

KW - antiplatelet drugs

KW - database

KW - epidemiology

KW - prevention

KW - sex

KW - stroke management

KW - GENERAL-PRACTICE

KW - ATRIAL-FIBRILLATION

KW - CONTROLLED TRIAL

KW - BLOOD-PRESSURE

KW - HEART-DISEASE

KW - MANAGEMENT

KW - RISK

KW - INDIVIDUALS

KW - MORBIDITY

KW - INEQUALITIES

U2 - 10.1161/01.STR.0000173398.99163.9e

DO - 10.1161/01.STR.0000173398.99163.9e

M3 - Article

VL - 36

SP - 1771

EP - 1775

JO - Stroke

JF - Stroke

SN - 0039-2499

ER -