Women and men with premature ASCVD report worse health care access and physical and mental health

According to a study published in JAMA Cardiology.

Investigators sought to explore the association of gender with domains of physical and mental health, as well as access to health care, in adults with self-reported premature ASCVD. The researchers conducted a retrospective analysis between 2016 and 2019 using data from adults enrolled in the US Behavioral Risk Factor Surveillance System (BRFSS) survey. Participants between the ages of 18 and 55 were identified using the BRFSS. All relevant data were reviewed from June to July 2021. In this analysis, self-reported ASCVD was defined as “having a history of coronary heart disease, myocardial infarction, or stroke.” The primary outcome measures of the study were self-reported physical and mental health, as well as measures of health care access, which included self-reported cost-associated medication non-adherence and inability to seek medical attention. due to cost.

Among 748,090 adults aged 18 to 55 who were identified between 2016 and 2019, a total of 28,522 had self-reported premature ASCVD. Overall, 47.0% of identified individuals were female. Following a multivariate logistic regression analysis, women compared to men with premature ASCVD were significantly more likely to report poor overall physical health (odds ratio [OR], 1.39; 95% CI, 1.09 to 1.78; P = 0.008), clinical depression (OR, 1.73; 95% CI, 1.41 to 2.14; P P = 0.005), and inability to see a doctor due to cost-related issues (OR, 4.52; 95% CI, 2.24 to 9.13; P <.001>


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These results were despite the fact that women were statistically significantly more likely than men to have health care coverage (85.3% versus 80.8%, respectively; P =0.04) and having a primary care physician (84.2% versus 75.7%, respectively; P <.001>

The researchers concluded that the results of the current study show that interventions designed to address mental health and personal expenses are badly needed in the adult patient population with premature ASCVD.

“These findings underscore the importance of reducing cardiovascular disparities by encouraging policy-level efforts that advocate for the integration of social determinants of health into existing clinical childbirth support systems and encourage investments in the development of social risk assessment tools that allow physicians to specifically target this vulnerable population,” the study authors noted. “Finally, our findings highlight the need for policy-level interventions to address the direct costs for this young patient population. »

Disclosure: Some of the study authors have disclosed affiliations with biotechnology, pharmaceutical and/or device companies. Please see the original citation for a full list of author disclosures.

Reference

Jain V, Al Rifai M, Turpin R, et al. Assessment of factors underlying gender-based disparities in cardiovascular care in adults with self-reported premature atherosclerotic cardiovascular disease. JAMA-cardiol. Published online January 5, 2022. doi:10.1001/jamacardio.2021.5430.

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