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Evaluation

Oral Presentation

Session: Beyond Borders: Health Disparities in the US and Europe

Unravelling Sex Disparities in Statin Dose Titration Patterns in Primary Care.

Wednesday, August 28, 2024
8:45 AM – 9:00 AM CEST
Location: Auditorium

    Presenting Author(s)

  • Pauline Kiss, MSc

    PhD candidate
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands, Netherlands

    Slides

    • Co-Author(s)

  • Alicia Uijl, PhD

    Assistant professor
    Department of Cardiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands, Netherlands

  • TD

    Tessa Duk, MSc

    PhD Candidate
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands, Netherlands

  • DG

    Diederick E. Grobbee, PhD

    Professor of Clinical Epidemiology
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands, Netherlands

  • MH

    Monika Hollander

    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands, Netherlands

  • Elisabeth Smits

    PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands.
    Utrecht, Netherlands

  • Miriam C.J.M. Sturkenboom, PhD

    Professor
    Department of Data Science & Biostatistics, Julius Global Health, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
    Utrecht, Netherlands

  • SP

    Sanne Peters

    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands, Netherlands

Background: Statins are widely used for the prevention and management of cardiovascular disease (CVD). Women receive lower statin intensities than men and are less likely to achieve cholesterol targets.

Objectives: This study aims to examine sex differences in titration patterns of statin therapy and in the attainment of cholesterol targets in a Dutch primary care setting.

Methods: Data on statin dispensing was extracted from the PHARMO Data Network between 2011-2020. New-statin users with at least two recorded statin dispensing were included. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between sex and time to first uptitration. Poisson regressions with robust standard errors was used to estimate risk ratios (RR) with 95%CI of sex differences in the attainment of cholesterol target within six and eighteen months after statin initiation.

Results: We identified 68,150 new users of statin therapy (46% women) with a median age of 65 years old [Interquartile Range 57 – 72]. The cumulative incidence of uptitration after three years of follow-up was 11% in women and 13% in men. Women were 24% less likely to be uptitrated compared to men (adjusted HR for women vs men 0.76 (95%CI 0.72 – 0.79)). The adjusted RR of achieving cholesterol target levels within six and eighteen months in women vs men were 0.95 (95%CI 0.92 – 0.97) and 0.98 (95%CI 0.96 – 0.99).

Conclusions: Among new statin users, women were less likely to be uptitrated compared to men and to achieve cholesterol target levels.