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Study: Women Less Likely to Receive Some Heart Medicines

CardioSmart News
Women who are either at high risk for or who have known cardiovascular disease aren’t being prescribed medications to lower their heart risk as often as men, new research finds

The findings, published in the Journal of the American Heart Association, shed light on critical gaps in the use of these medications by primary care providers. The research also underscores the need for efforts to make sure that anyone who should be taking these potentially lifesaving medications gets a prescription, authors urged. 

“Future research is needed to determine the underlying cause of observed sex differences and to develop tailored strategies to optimize the use of evidence-based cardiovascular medication for both women and men,” the authors write.

For this study, the researchers conducted a systematic review of two large medical databases and included 43 studies in their analysis that had collected data on primary care prescriptions of medications to manage cardiovascular disease. These included, for example, statins to help lower cholesterol, aspirin to prevent blood clots, and angiotensin-converting enzyme (ACE) inhibitors and diuretics to help lower blood pressure. 

The study, which included data from 2.2 million patients worldwide of whom 28% were women, showed that, compared with men, women were less likely to be prescribed aspirin, statins or ACE-inhibitors, but they were 27% more likely to be given a diuretic. Overall, women received:
  • 10% fewer prescription than men
  • 19% fewer prescriptions for aspirin than men
  • 15% fewer prescriptions for ACE-inhibitors than men
Similar patterns were seen when researchers looked at women who already have cardiovascular disease and then at those at high risk of developing it. There were no differences in the prescription of beta blockers or calcium channel blockers. 

Researchers reported that age didn’t seem to play a role in how many women versus men were prescribed cardiovascular medicines. The exception was in studies that included older patients, men were more likely to be prescribed a statin, and in studies of younger patients, women were more often prescribed a statin. 

While it’s beyond the scope of this analysis, researchers discussed potential reasons for the gaps, including that women may have more adverse drug reactions. 

Cardiovascular disease remains the leading cause of death worldwide in both women and men. While lifestyle habits, such as exercising, eating a heart-healthy diet, keeping a healthy weight, and not smoking are at the core of lowering one’s risk of cardiovascular disease, medications are often needed as well. 

This study adds to research showing that women are less likely to be prescribed statins after a heart attack or reach treatment targets. They also are more likely to experience a delay in receiving appropriate medical treatment for a first or repeat cardiac event.

The study is limited in that it did not account for potential combinations of heart medications or for differences across the 43 separate studies. It also examined differences only in prescribing patterns and not the effects of these differences on cardiovascular risk and events.
Sex Differences in CV Medication RX in Primary Care: A Systematic Review and Meta‐Analysis,” Journal of the American Heart Association, May 20, 2020. Learn about CardioSmart's editorial process Information provided for educational purposes only. Please talk to your health care professional about your specific needs.