Gender differences in cardiovascular risk factor awareness: Results from the ESC EORP EUROASPIRE V Registry
Introduction
Despite efforts to increase the awareness on gender differences in the secondary prevention of patients with coronary heart disease (CHD), the risk factor profile of women remains substantially worse compared to men [[1], [2], [3], [4]]. Optimal risk factor control is, however, essential to decrease the risk of recurrent coronary events [5]. Previous evidence showed that the patients' awareness about their risk factor profile is positively related to a better control of their coronary risk factors [2]. Despite several actions to increase the awareness in CHD patients [1,6,7], risk factor knowledge in both men and women remains suboptimal [7,8]. Although the evidence on this topic is limited, some studies reported that women were even less aware of their cardiovascular risk factors and that they were less likely to be told by a healthcare professional that they were at CHD risk [[9], [10], [11]]. Nevertheless, insufficient evidence is available to determine whether patient awareness is different in women compared to men in the field of secondary CHD prevention. Moreover, previous evidence reported that patient awareness and patient education in cardiovascular risk factors may be influenced by their age and educational level [10,12].
A better understanding of gender differences in patient awareness is needed to optimize the CHD risk factor control in daily clinical practice. This is of particular interest for physical activity levels, obesity, and LDL-C targets, which are known to be worse in women compared to men [4]. Therefore, the aim of this study was to provide up-to-date evidence on existing gender differences in European CHD patients' risk factor awareness and in information provided by healthcare professionals, using data from the most recent ESC (European Society of Cardiology) EORP (EURObservational Research Programme) EUROASPIRE V (European Survey Of Cardiovascular Disease Prevention And Diabetes) survey. Particular emphasis was put on age and educational level.
Section snippets
Methods
Current analyses are based on the most recent ESC EORP EUROASPIRE V survey (2016–2017). The aim of the repeated cross-sectional EUROASPIRE surveys (since 1995), was to evaluate the implementation of the Joint European Society (JES) guidelines on cardiovascular disease prevention in daily clinical practice [13]. Detailed information on the study design and methodology has been reported elsewhere [14]. Within each country, at least one geographical area with a predefined population was selected.
Results
Data on 8261 CHD patients were available at the time of the study visit, of whom 2129 (25.8%) were women. Table 1 provides a detailed overview of the patient characteristics. Overall, women were significantly older than men, had a lower educational level and they were living more frequently in low/middle income countries. Moreover, women were more likely to have ischaemia as a recruiting event and a higher proportion of them had a history of stroke, heart failure and self-reported diabetes. In
Discussion
The current study provides an up-to date overview on existing gender differences in patient risk factor awareness, using data from the most recent EUROASPIRE V survey. Previous studies focused primarily on the level of awareness of the entire population of CHD patients, whereas this study focuses specifically on differences between men and women. The knowledge gained from this study is relevant for supporting healthcare professionals in applying a more specific approach in secondary CHD
Funding
The EUROASPIRE V survey was carried out under the auspices of the European Society of Cardiology, EURObservational Research Programme (EORP). Since the start of EORP, the following companies have supported the programme: Amarin, Amgen, Daiichi Sankyo, Elli Lily, Ferrer, Novo Nordisk, Pfizer, and Sanofi. The sponsors of the EUROASPIRE surveys had no role in the design, data collection, data analysis, data interpretation, decision to publish, or writing the manuscript. Pieter Vynckier is
Authors' statement
PV, DDB, and DDS contributed to the conception and design. PV, KK, SG, DDB, and DDS contributed to the acquisition, analysis, and interpretation. PV, DDB, and DDS drafted the manuscript. All authors critically revised the manuscript, gave final approval, and agree to be accountable for all aspects of work ensuring integrity and accuracy.
Declaration of Competing Interest
The authors declare that there is no conflict of interest related to this work.
Acknowledgements
The Registry Executive Committee and Steering Committee of the EURObservational Research Programme (EORP). Data collection was conducted by the EORP department of the ESC, by Céline Arsac as EORP Team Manager, Emanuela Fiorucci as Project Officer, Clara Berle as Clinical Project Manager and Viviane Missiamenou, Florian Larras and Gagan Chhabra as Data Managers. All investigators are listed in Appendix 1.
The EUROASPIRE Study Group is grateful to the administrative staff, physicians, nurses and
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- 1
Dirk De Bacquer and Delphine De Smedt should be considered shared senior authors.
- 2
Listed in Appendix 1.