Is there a gender gap in secondary prevention of coronary artery disease in Turkey? [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2018; 46(8): 683-691 | DOI: 10.5543/tkda.2018.45392

Is there a gender gap in secondary prevention of coronary artery disease in Turkey?

Duygu Koçyiğit1, Lale Tokgözoğlu2, Meral Meral Kayıkçıoğlu3, Servet Altay4, Sinan Aydoğdu5, Cem Barçın6, Cem Bostan7, Hüseyin Altuğ Çakmak8, Alp Burak Çatakoğlu9, Samim Emet10, Oktay Ergene11, Ali Kemal Kalkan12, Barış Kaya2, Cansın Kaya13, Cihangir Kaymaz14, Nevrez Koylan15, Hakan Kültürsay3, Aytekin Oğuz16, Ebru Özpelit17, Serkan Ünlü18
1Cardiology Clinics, Afyonkarahisar Dinar State Hospital, Afyonkarahisar, Turkey
2Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
3Department of Cardiology, Ege University Faculty of Medicine, İzmir, Turkey
4Cardiology Clinics, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
5Cardiology Clinics, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
6Cardiology Clinics, Gülhane Training and Research Hospital, Ankara, Turkey
7Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey.
8Department of Cardiology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
9Department of Cardiology, İstinye University Faculty of Medicine, İstanbul, Turkey
10Department of Cardiology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
11Department of Cardiology, Izmir Kâtip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
12Cardiology Clinics, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
13Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey.
14Cardiology Clinics, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Istanbul, Turkey.
15Cardiology Clinics, Gebze Anadolu Medical Center, Izmit, Turkey.
16Internal Medicine Clinics, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
17Department of Cardiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
18Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey


OBJECTIVE
It has been reported that women receive fewer preventive recommendations regarding pharmacological treatment, lifestyle modifications, and cardiac rehabilitation compared with men who have a similar risk profile. This study was an investigation of the impact of gender on cardiovascular risk profile and secondary prevention measures for coronary artery disease (CAD) in the Turkish population.

METHODS
Statistical analyses were based on the European Action on Secondary and Primary Prevention through Intervention to Reduce Events (EUROASPIRE)-IV cross-sectional survey data obtained from 17 centers in Turkey. Male and female patients, aged 18 to 80 years, who were hospitalized for a first or recurrent coronary event (coronary artery bypass graft, percutaneous coronary intervention, acute myocardial infarction, or acute myocardial ischemia) were eligible.

RESULTS
A total of 88 (19.7%) females and 358 males (80.3%) were included. At the time of the index event, the females were significantly older (p=0.003) and had received less formal education (p<0.001). Non-smoking status (p<0.001) and higher levels of depression and anxiety (both p<0.001) were more common in the female patients. At the time of the interview, conducted between 6 and 36 months after the index event, central obesity (p<0.001) and obesity (p=0.004) were significantly more common in females. LDL-C, HDL-C or HbA1c levels did not differ significantly between genders. The fasting blood glucose level was significantly higher (p=0.003) and hypertension was more common in females (p=0.001). There was no significant difference in an increase in physical activity or weight loss after the index event between genders, and there was no significant difference between genders regarding continuity of antiplatelet, statin, beta blocker or ACEi/ARB II receptor blocker usage (p>0.05).

CONCLUSION
Achievement of ideal body weight, fasting blood glucose and blood pressure targets was lower in women despite similar reported medication use. This highlights the importance of the implementation of lifestyle measures and adherence to medications in women.

Keywords: Cardiovascular risk factors, coronary artery disease; gender; secondary prevention.

How to cite this article
Duygu Koçyiğit, Lale Tokgözoğlu, Meral Meral Kayıkçıoğlu, Servet Altay, Sinan Aydoğdu, Cem Barçın, Cem Bostan, Hüseyin Altuğ Çakmak, Alp Burak Çatakoğlu, Samim Emet, Oktay Ergene, Ali Kemal Kalkan, Barış Kaya, Cansın Kaya, Cihangir Kaymaz, Nevrez Koylan, Hakan Kültürsay, Aytekin Oğuz, Ebru Özpelit, Serkan Ünlü. Is there a gender gap in secondary prevention of coronary artery disease in Turkey?. Turk Kardiyol Dern Ars. 2018; 46(8): 683-691

Corresponding Author: Lale Tokgözoğlu, Türkiye
© Copyright 2018 Archives of the Turkish Society of Cardiology
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