Challenges in Sex- and Gender-Centered Prevention and Management of Cardiovascular Disease: Implications of Genetic, Metabolic, and Environmental Paths

Kouvari, Matina; Yannakoulia, Mary; Souliotis, Kyriakos; Panagiotakos, Demosthenes B.

doi:10.1177/0003319718756732

Cited by 24 publications

(14 citation statements)

References 77 publications

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“…The present study also demonstrated that the generic clopidogrel formulation is equally effective in different subgroups, including different genders, within the studied population. Stratified analyses with gender as strata are important to confirm the drug efficacy against major events as well as its safety [ 25 ]. In the present work, both the statistical (in terms of p for interaction) and the clinical (in terms of stratified risk analysis) gender–treatment interaction were evaluated, but no significant differences were observed ( Figures 1 and 2 ).…”

Section: Discussionmentioning

confidence: 99%

The incidence of recurrent cardiovascular events among acute coronary syndrome patients treated with generic or original clopidogrel in relation to their sociodemographic and clinical characteristics. The Aegean study

Patsourakos

Kouvari

Kotidis

et al. 2020

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Introduction The use of generic drugs is continuously growing; however, there are limited epidemiological data regarding the therapeutic equivalence of each original drug formulation with its generic counterparts. We evaluated the 12-month composite endpoint of recurrent acute myocardial infarction, ischaemic stroke, cardiac deaths, or hospitalisation due to a major bleeding in acute coronary syndrome (ACS) patients treated with original clopidogrel or a generic clopidogrel formulation, in relation to sociodemographic and clinical characteristics. Material and methods Consecutive Greek ACS patients ( n = 1194) hospitalised in the Aegean islands and the Attica region were enrolled. Clopidogrel treatment was recorded either as original clopidogrel hydrogen sulphate (Plavix ® /Iscover ® ) or as a generic clopidogrel besylate formulation (Clovelen ® ). The composite endpoint was recorded at 12-month follow-up. Results The 12-month composite endpoint was 3.9% (4.6% in the Aegean islands and 3.5% in the Attica area, p > 0.05). The respective incidence in men was 4.0% and in women 3.8% ( p > 0.05). Overall, generic and original clopidogrel use was 87% and 13% of patients, respectively. No significant differences were observed between original and generic clopidogrel use and 12-month composite endpoint incidence. Subgroup analysis with gender, region of residence, and clinical and lifestyle factors as strata did not reveal any significant outcomes. Haemorrhage incidence did not exceed 1% in the total sample. Conclusions The use of a generic clopidogrel besylate formulation was quite high in both urban and insular areas of Greece and had similar efficacy and safety profile with the original clopidogrel salt, supporting the routine use of this low-cost generic clopidogrel in the management of cardiovascular disease patients.

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Section: Discussionmentioning

confidence: 99%

The incidence of recurrent cardiovascular events among acute coronary syndrome patients treated with generic or original clopidogrel in relation to their sociodemographic and clinical characteristics. The Aegean study

Patsourakos

Kouvari

Kotidis

et al. 2020

aoms

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“…However, the finding that men with dementia use more lipid-lowering therapies suggests that cardiac comorbidities are more common in community-dwelling men with dementia 63 but may also reflect known differences in cardiovascular comorbidity identification and treatment between men and women in the general population. 68…”

Section: Discussionmentioning

confidence: 99%

Sex and gender differences in polypharmacy in persons with dementia: A scoping review

2019

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Purpose: To date, research studies in most disciplines have not made sex-based analysis a priority despite increasing evidence of its importance. We now understand that both sex and gender impact medication prescribing, use, and effect. This is particularly true for older adults with dementia who have alterations in drug metabolism, drug response, and the permeability of the blood–brain barrier. To better understand the influence of sex and gender on drug use in older adults with dementia, we conducted a scoping review. Methods: This scoping review systematically searched the Medline, Embase, Web of Science, CINAHL, and ProQuest databases to find published reports on polypharmacy in populations of older adults with dementia that included a sex- or gender-based analysis. Results: A total of 12 published reports were identified. Findings were cohort studies and case-control trials that commented on sex-related differences in medication use as a secondary analysis to the studies’ primary objective. These studies showed that community-dwelling women received more potentially inappropriate medications and more psychotropic medications, while nursing home dwelling men received more potentially inappropriate medications, cholinesterase inhibitors, and antipsychotics. None of the identified studies explicitly examined gender-related differences in medication use. Conclusion: This scoping review supports that there is inadequate understanding of both sex and gender differences in drug use in older men and women with dementia. To tailor medication-specific interventions to improve drug therapy for older adults with dementia, it is important that future work includes sex- or gender-based analysis of drug use.

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“…7,8 In this context, women are to wait longer between seeking and receiving medical advice. 9 On the other hand, female patients are susceptible to underdiagnosis, inappropriate therapeutic decisions, or even remaining untreated, as physicians usually underestimate their risk burden. 10,11 Therefore, it is considered that the time has come for a sustained effort and commitment to encompass in the women's health agenda tailor-made strategic plans regarding the effective prevention and management of CVD.…”

Section: Introductionmentioning

confidence: 99%

<p>Cardiovascular Diseases in Women: Policies and Practices Around the Globe to Achieve Gender Equity in Cardiac Health</p>

Kouvari¹,

Souliotis²,

Yannakoulia³

et al. 2020

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The women's global health agenda has recently been reformulated to address more accurately cardiovascular disease (CVD) prevention, diagnosis, and treatment. The aim of the present work was to review the global and national policies and practices that address sex equality in health with a focus on CVDs in women. Scientific databases and health organizations' websites that presented/discussed policies and initiative targeting to enhance a sex-centered approach regarding general health and/or specifically cardiac health care were reviewed in a systematic way. In total, 61 relevant documents were selected. The selected policies and initiatives included position statements, national action plans, evidence-based guidelines, guidance/recommendations, awareness campaigns, regulations/legislation, and state-of-the art reports by national/international projects and conferences. The target audiences of large stakeholders (eg, American Heart Association, European Society of Cardiology, Centers for Disease Control and Prevention) were female citizens, health professionals, and researchers. Much as policy-makers have recognized the sex/gender gap in the CVD field, there is still much to be done. Thereby, tailor-made strategies should be designed, evaluated, and delivered on a global and most importantly a national basis to achieve gender equity with regard to CVDs.

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Challenges in Sex- and Gender-Centered Prevention and Management of Cardiovascular Disease: Implications of Genetic, Metabolic, and Environmental Paths

Cited by 24 publications

References 77 publications

The incidence of recurrent cardiovascular events among acute coronary syndrome patients treated with generic or original clopidogrel in relation to their sociodemographic and clinical characteristics. The Aegean study

The incidence of recurrent cardiovascular events among acute coronary syndrome patients treated with generic or original clopidogrel in relation to their sociodemographic and clinical characteristics. The Aegean study

Sex and gender differences in polypharmacy in persons with dementia: A scoping review

<p>Cardiovascular Diseases in Women: Policies and Practices Around the Globe to Achieve Gender Equity in Cardiac Health</p>

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