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Cholesterol in women at high cardiovascular risk is less successfully treated than in corresponding men

The Skaraborg Hypertension and Diabetes Project

European Journal of Clinical Pharmacology volume 64, pages 815–820 (2008)Cite this article

Abstract

Objective

To assess the use of lipid-lowering therapy in patients with known coronary heart disease (CHD), cerebrovascular disease or diabetes in a community-based population in Sweden considering expert recommendations.

Methods

A random sample of individuals aged ≥40 years who were surveyed in 1993–1994 were revisited 10 years later during 2003–2004 (n = 724). A clinical investigation focused on cardiovascular risk including serum total cholesterol. Information on medical history and current medication was collected in structured interviews.

Results

Eighty-two patients (11.3%) reported a history of CHD, including 51 men and 31 women. Fifty-three patients fulfilled criteria for treatment and most of them (85%) were on lipid-lowering therapy. A higher fraction of women were treated; however only 13% of them reached target cholesterol levels compared to 37% of the men (P < 0.001). Sixty-five subjects (9.0%) had diabetes and/or a previous stroke (29 men, 36 women) but no previous CHD. Patients with CHD were more likely to be treated compared to patients with diabetes and/or stroke but no CHD (85.0 vs. 28.5%, OR 6.0, 95% CI 2.2–16.9, P = 0.01). In a total of 79 participants (10.9%) who were on lipid-lowering therapy, women reached a total serum cholesterol level below 5.0 mmol/L less often than men (26.3 vs. 63.4%, P < 0.001).

Conclusions

A considerable proportion of patients in primary care were untreated despite current guidelines on lipid-lowering therapy. Treatment outcome in women was less efficient compared with men. Strategies to improve pharmacological treatment in these patients should be developed.

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Acknowledgements

We are most grateful to all those residents in Skara who participated in this study and to Mrs Ann Segerblom and Mrs Birgitta Lindberg for valuable technical assistance.

Author information

Affiliations

  1. Skara Health Care Centre, Skövde, Sweden

    Anita Mehner

  2. R&D Centre, Skaraborg Primary Care, Storgatan 18, S-541 30, Skövde, Sweden

    Ulf Lindblad & Kristina Bengtsson Boström

  3. Department of Clinical Sciences, Community Medicine, Malmö University Hospital, Lund University, Malmö, Sweden

    Ulf Lindblad, Lennart Råstam & Kristina Bengtsson Boström

  4. Skaraborg Institute Skövde, Skövde, Sweden

    Ulf Lindblad

Authors
  1. Anita Mehner
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  2. Ulf Lindblad
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  3. Lennart Råstam
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  4. Kristina Bengtsson Boström
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Corresponding author

Correspondence to Kristina Bengtsson Boström.

Additional information

This research was funded by the Swedish Medical Research Council, Skaraborg Institute, Skaraborg Primary Care, Health and Medical Care Executive Board of the Region Västra Götaland, NEPI foundation, Lund University Faculty of Medicine, and Malmö University Hospital.

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Mehner, A., Lindblad, U., Råstam, L. et al. Cholesterol in women at high cardiovascular risk is less successfully treated than in corresponding men. Eur J Clin Pharmacol 64, 815–820 (2008). https://doi.org/10.1007/s00228-008-0482-x

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  • DOI: https://doi.org/10.1007/s00228-008-0482-x

Keywords

  • Lipid-lowering drugs
  • Guidelines
  • Primary care
  • Coronary heart disease
  • Diabetes
  • Cerebrovascular disease