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Secondary prevention care and effect: total and low-density lipoprotein cholesterol levels and lipid-lowering drug use in women and men after incident myocardial infarction - the Tromso Study 1994-2016
Hopstock, Laila Arnesdatter Eggen, Anne Elise Loechen, Maja-Lisa Mathiesen, Ellisiv Bøgeberg Njolstad, Inger Wilsgaard, Tom
Hopstock, Laila Arnesdatter
Eggen, Anne Elise
Loechen, Maja-Lisa
Mathiesen, Ellisiv Bøgeberg
Njolstad, Inger
Wilsgaard, Tom
Abstract
Background:
Secondary prevention guidelines after myocardial infarction (MI) are gender neutral, but underutilisation of treatment in women has been reported.
Design:
We investigated the change in total and low-density lipoprotein (LDL) cholesterol levels and lipid-lowering drug (LLD) use after first-ever MI in a population-based study.
Methods:
We followed 10,005 participants (54% women) attending the Tromsø Study 1994–1995 and 8483 participants (55% women) attending the Tromsø Study 2007–2008 for first-ever MI up to their participation in 2007–2008 and 2015–2016, respectively. We used linear and logistic regression models to investigate sex differences in change in lipid levels.
Results:
A total of 395 (MI cohort I) and 132 participants (MI cohort II) had a first-ever MI during 1994–2008 and 2007–2013, respectively. Mean change in total cholesterol was −2.34 mmol/L (SD 1.15) in MI cohort I, and in LDL cholesterol was −1.63 mmol/L (SD 1.12) in MI cohort II. Men had a larger decrease in lipid levels compared to women: the linear regression coefficient for change was −0.33 (95% confidence interval [CI] −0.51 to −0.14) for total cholesterol and −0.21 (95% CI −0.37 to −0.04) for LDL cholesterol, adjusted for baseline lipid value, age and cohort. Men had 73% higher odds (95% CI 1.15−2.61) of treatment target achievement compared to women, adjusted for baseline lipid value, age and cohort. LLD use was reported in 85% of women and 92% of men in MI cohort I, and 80% in women and 89% in men in MI cohort II.
Conclusions:
Compared to men, women had significantly less decrease in lipid levels after MI, and a smaller proportion of women achieved the treatment target.
Keywords
Anticholesterolaemic agents, cohort studies, gender differences, lipids, myocardial infarction, secondary prevention care
Date
2018
Type
Journal article
Journal
European Journal of Cardiovascular Nursing
Book
Volume
17
Issue
6
Page Range
563-570
Article Number
ACU Department
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Open Access Status
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Controlled