Gender Differences in Patient‐Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease

Abstract

Background Atherosclerotic cardiovascular disease ( ASCVD ) accounts for approximately one third of deaths in women. Although there is an established relationship between positive patient experiences, health‐related quality of life, and improved health outcomes, little is known about gender differences in patient‐reported outcomes among ASCVD patients. We therefore compared gender differences in patient‐centered outcomes among individuals with ASCVD . Methods and Results Data from the 2006 to 2015 Medical Expenditure Panel Survey, a nationally representative US sample, were used for this study. Adults ≥18 years with a diagnosis of ASCVD , ascertained by International Classification of Diseases, Ninth Revision ( ICD‐9) codes and/or self‐reported data, were included. Linear and logistic regression were used to compare self‐reported patient experience, perception of health, and health‐related quality of life by gender. Models adjusted for demographics, socioeconomic status, and comorbidities. There were 21 353 participants included, with >10 000 (47%‐weighted) of the participants being women, representing ≈11 million female adults with ASCVD nationwide. Compared with men, women with ASCVD were more likely to experience poor patient–provider communication (odds ratio 1.25 [95% confidence interval 1.11–1.41]), lower healthcare satisfaction (1.12 [1.02–1.24]), poor perception of health status (1.15 [1.04–1.28]), and lower health‐related quality of life scores. Women with ASCVD also had lower use of aspirin and statins, and greater odds of ≥2 Emergency Department visits/y. Conclusions Women with ASCVD were more likely to report poorer patient experience, lower health‐related quality of life, and poorer perception of their health when compared with men. These findings have important public health implications and require more research towards understanding the gender‐specific differences in healthcare quality, delivery, and ultimately health outcomes among individuals with ASCVD .

Polygenic risk for coronary heart disease acts through atherosclerosis in type 2 diabetes

“…Sex/gender differences have been reported in patients with atherosclerotic cardiovascular diseases [42]. Importantly, women with diabetes have been reported to be at greater risk for CHD and more likely experience adverse outcomes [43].…”

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

“…There were well described biases in favour of men in terms of accurate diagnosis and active management late last century, including transfer to appropriate facilities and less use of interventions that were thought to contribute to a poorer outcome in women [81][82][83][84]. There continues to be evidence that women are likely to be managed more conservatively and with less intervention than men, despite underlying differences in the disease processes that account for some of the differences in how males and females are treated [85][86][87]. This could be due, in part, to aetiologic differences in ACS between women and men, with Type 2 MI (caused by imbalance between oxygen demand and supply, such as microvascular dysfunction) being more common in women than men [88].…”

Considering the gender gap in heart failure

“…31 Specifically, women often noted a lack of respect, time, and attentiveness given by their providers as reasons for poor patient-provider communication. 31 Effective communication between patients and providers has been shown to be associated with better health outcomes. 32 The higher dissatisfaction rate seen in women with their healthcare providers is concerning and further emphasizes the discrepancy experienced by women.…”