Gender inequalities in the management of angina pectoris: cross sectional survey in primary care

Michael A Crilly, P. E. ,. Bundred

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and Aims: To determine the extent of gender differences in the routine clinical care of patients with angina pectoris in primary care. Methods: A cross-sectional survey of general practitioner (GP) medical records undertaken by trained data managers in 6 GP practices. 925 adults (489 men) with a clinical diagnosis of angina (prevalence = 2.4%, 95%CI 2.3-2.6). Data extracted included: level of care; risk factor recording; prescribed medication; exercise ECG and coronary revascularisation. Adjusted male-to-female odds ratios (AOR) adjusted for age, angina duration, and previous myocardial infarction, (MI). Results: Women with angina were older than men (71 v 65 years) with a lower prevalence of MI (30 v 45%), but a longer duration of angina (5 v 4years). Men were more likely to receive once daily aspirin (AOR= 2.07, 95%CI 1.56-2.74) and be prescribed triple anti-anginal therapy (1.58, 95%CI 1.03-2.42). Men were also significantly more likely to undergo exercise ECG (1-56, 95%CI 1.14-2.15) and surgical revascularisation (1,71, 95%CI 1.03-2.85). Women tended to receive GP care alone (AOR=0.64, 95%CI 0.46-0.89), whilst men received specialist cardiac care (1.47, 95%CI 1.09-2.00). Beta-blocker usefollowing MI was similar (0.99, 95%CI 0.59-1.69). Conclusion: Differences in the management of men and women are unaccounted for by differences in age, previous MI or duration of angina. Gender differences in management of CHD reported from secondary care may also exist in primary care.

Original languageEnglish
Pages (from-to)154-158
Number of pages4
JournalScottish Medical Journal
Volume50
Issue number4
Publication statusPublished - 2005

Keywords

  • angina pectoris
  • cross-sectional survey
  • gender inequalities
  • primary health care
  • ACUTE MYOCARDIAL-INFARCTION
  • CORONARY-ARTERY DISEASE
  • EVIDENCE-BASED GUIDELINE
  • HEART-DISEASE
  • SEX BIAS
  • BYPASS-SURGERY
  • STABLE ANGINA
  • WOMEN
  • MEN
  • PREVALENCE

Cite this

Gender inequalities in the management of angina pectoris: cross sectional survey in primary care. / Crilly, Michael A; Bundred, P. E. ,.

In: Scottish Medical Journal, Vol. 50, No. 4, 2005, p. 154-158.

Research output: Contribution to journalArticle

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abstract = "Background and Aims: To determine the extent of gender differences in the routine clinical care of patients with angina pectoris in primary care. Methods: A cross-sectional survey of general practitioner (GP) medical records undertaken by trained data managers in 6 GP practices. 925 adults (489 men) with a clinical diagnosis of angina (prevalence = 2.4{\%}, 95{\%}CI 2.3-2.6). Data extracted included: level of care; risk factor recording; prescribed medication; exercise ECG and coronary revascularisation. Adjusted male-to-female odds ratios (AOR) adjusted for age, angina duration, and previous myocardial infarction, (MI). Results: Women with angina were older than men (71 v 65 years) with a lower prevalence of MI (30 v 45{\%}), but a longer duration of angina (5 v 4years). Men were more likely to receive once daily aspirin (AOR= 2.07, 95{\%}CI 1.56-2.74) and be prescribed triple anti-anginal therapy (1.58, 95{\%}CI 1.03-2.42). Men were also significantly more likely to undergo exercise ECG (1-56, 95{\%}CI 1.14-2.15) and surgical revascularisation (1,71, 95{\%}CI 1.03-2.85). Women tended to receive GP care alone (AOR=0.64, 95{\%}CI 0.46-0.89), whilst men received specialist cardiac care (1.47, 95{\%}CI 1.09-2.00). Beta-blocker usefollowing MI was similar (0.99, 95{\%}CI 0.59-1.69). Conclusion: Differences in the management of men and women are unaccounted for by differences in age, previous MI or duration of angina. Gender differences in management of CHD reported from secondary care may also exist in primary care.",
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N2 - Background and Aims: To determine the extent of gender differences in the routine clinical care of patients with angina pectoris in primary care. Methods: A cross-sectional survey of general practitioner (GP) medical records undertaken by trained data managers in 6 GP practices. 925 adults (489 men) with a clinical diagnosis of angina (prevalence = 2.4%, 95%CI 2.3-2.6). Data extracted included: level of care; risk factor recording; prescribed medication; exercise ECG and coronary revascularisation. Adjusted male-to-female odds ratios (AOR) adjusted for age, angina duration, and previous myocardial infarction, (MI). Results: Women with angina were older than men (71 v 65 years) with a lower prevalence of MI (30 v 45%), but a longer duration of angina (5 v 4years). Men were more likely to receive once daily aspirin (AOR= 2.07, 95%CI 1.56-2.74) and be prescribed triple anti-anginal therapy (1.58, 95%CI 1.03-2.42). Men were also significantly more likely to undergo exercise ECG (1-56, 95%CI 1.14-2.15) and surgical revascularisation (1,71, 95%CI 1.03-2.85). Women tended to receive GP care alone (AOR=0.64, 95%CI 0.46-0.89), whilst men received specialist cardiac care (1.47, 95%CI 1.09-2.00). Beta-blocker usefollowing MI was similar (0.99, 95%CI 0.59-1.69). Conclusion: Differences in the management of men and women are unaccounted for by differences in age, previous MI or duration of angina. Gender differences in management of CHD reported from secondary care may also exist in primary care.

AB - Background and Aims: To determine the extent of gender differences in the routine clinical care of patients with angina pectoris in primary care. Methods: A cross-sectional survey of general practitioner (GP) medical records undertaken by trained data managers in 6 GP practices. 925 adults (489 men) with a clinical diagnosis of angina (prevalence = 2.4%, 95%CI 2.3-2.6). Data extracted included: level of care; risk factor recording; prescribed medication; exercise ECG and coronary revascularisation. Adjusted male-to-female odds ratios (AOR) adjusted for age, angina duration, and previous myocardial infarction, (MI). Results: Women with angina were older than men (71 v 65 years) with a lower prevalence of MI (30 v 45%), but a longer duration of angina (5 v 4years). Men were more likely to receive once daily aspirin (AOR= 2.07, 95%CI 1.56-2.74) and be prescribed triple anti-anginal therapy (1.58, 95%CI 1.03-2.42). Men were also significantly more likely to undergo exercise ECG (1-56, 95%CI 1.14-2.15) and surgical revascularisation (1,71, 95%CI 1.03-2.85). Women tended to receive GP care alone (AOR=0.64, 95%CI 0.46-0.89), whilst men received specialist cardiac care (1.47, 95%CI 1.09-2.00). Beta-blocker usefollowing MI was similar (0.99, 95%CI 0.59-1.69). Conclusion: Differences in the management of men and women are unaccounted for by differences in age, previous MI or duration of angina. Gender differences in management of CHD reported from secondary care may also exist in primary care.

KW - angina pectoris

KW - cross-sectional survey

KW - gender inequalities

KW - primary health care

KW - ACUTE MYOCARDIAL-INFARCTION

KW - CORONARY-ARTERY DISEASE

KW - EVIDENCE-BASED GUIDELINE

KW - HEART-DISEASE

KW - SEX BIAS

KW - BYPASS-SURGERY

KW - STABLE ANGINA

KW - WOMEN

KW - MEN

KW - PREVALENCE

M3 - Article

VL - 50

SP - 154

EP - 158

JO - Scottish Medical Journal

JF - Scottish Medical Journal

SN - 0036-9330

IS - 4

ER -