CHICAGO — The gender gap in lipid management hasn't narrowed since the March 2004 publication of American Heart Association evidence-based guidelines on prevention of cardiovascular disease in women, Dr. Lori Mosca reported at the annual scientific sessions of the AHA.
The percentage of high-risk women in two large southeastern health plans who had an LDL cholesterol level below 100 mg/dL rose from 33% before release of the gender-specific guidelines to 40% afterward. Meanwhile, the proportion of high-risk men with an LDL cholesterol level below 100 mg/dL rose from 41% to 50%. So the absolute difference in rates of good lipid control between men and women—the gender gap—climbed from 8% prior to release of the guidelines to 10% afterward, said Dr. Mosca, director of preventive cardiology at New York-Presbyterian Hospital.
Lipid control clearly remains suboptimal in both sexes, she added, since half of high-risk men and 60% of high-risk women had LDL cholesterol values above the National Cholesterol Education Program (NCEP) target of 100 mg/dL.
The NCEP optional, more aggressive goal—an LDL level below 70 mg/dL—was achieved in 10% of men and 6% of women prior to the AHA gender-specific guidelines, and in 15% of men and 10% of women later.
Dr. Mosca's retrospective study used administrative claims data for 17,070 men and 17,357 women. All had known cardiovascular disease or diabetes.
In an analysis controlling for age, metabolic syndrome, comorbidity, and other factors, high-risk women were 32% less likely than men to attain an LDL cholesterol level below 100 mg/dL and 36% less likely to have a level below 70 mg/dL.Women, however, were more likely to attain HDL cholesterol and triglyceride goals.