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Background <p>The burden of cardiovascular diseases (CVDs) must be reduced through prevention. This study aimed to assess sex differences in the implementation of secondary and primary prevention of CVDs based on risk factor levels among 75-year-old community-dwelling Finns.</p> Methods <p>The study included 75-year-old participants of the Turku Senior Health Clinic Study with CVD (<i>n</i> = 260) or with high or very high 5-year risk for CVD according to SCORE2-OP (<i>n</i> = 361). The achievement of low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG) levels, as well as the use of evidence-based medications recommended by disease-specific treatment guidelines, were assessed. Logistic regression analysis was used to explore sex differences in achieving national treatment targets.</p> Results <p>In the secondary prevention of CVD, more men than women achieved the treatment target levels for LDL-C (38% vs. 25%, respectively) (OR 1.82, 95% CI 1.07–3.11), SBP (18% vs. 9%) (OR 2.24, 95% CI 1.05–4.79), and DBP (41% vs. 30%) (OR 1.69, 95% CI 1.01–2.82). Additionally, men were more likely than women to use lipid-lowering (82% vs. 70%) (OR 1.95, 95% CI 1.08–3.49) and diabetes (27% vs. 14%) (OR 2.16, 95% CI 1.15–4.05) medications. Among those using antihypertensives, men were more likely than women to meet the treatment target levels for SBP (19% vs. 9%) (OR 2.36, 95% CI 1.03–5.43) and DBP (43% vs. 30%) (OR 1.78, 95% CI 1.01–3.13). In the primary prevention of CVD, the only significant sex differences were observed in the use of antihypertensive medications: men were less likely than women to use agents acting on the renin-angiotensin system (45% vs. 62%) (OR 0.49, 95% CI 0.32–0.74) or any antihypertensive medications (57% vs. 74%) (OR 0.46, 95% CI 0.29–0.72).</p> Conclusions <p>In primary care, there is a need for improvements in both secondary and primary prevention of CVDs in older adults, particularly in addressing elevated SBP and LDL-C levels. Moreover, the insufficient treatment of women in secondary prevention is a significant concern.</p> Trial registration <p>ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.</p>

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Sex differences in the secondary and primary prevention of cardiovascular diseases among 75-year-olds in Southwest Finland: a population-based study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月24日

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  • Marika Salminen,
  • Maika Kummel,
  • Jaana Koskenniemi,
  • Tero Vahlberg,
  • Matti Viitanen,
  • Päivi Korhonen,
  • Laura Viikari

摘要

Background

The burden of cardiovascular diseases (CVDs) must be reduced through prevention. This study aimed to assess sex differences in the implementation of secondary and primary prevention of CVDs based on risk factor levels among 75-year-old community-dwelling Finns.

Methods

The study included 75-year-old participants of the Turku Senior Health Clinic Study with CVD (n = 260) or with high or very high 5-year risk for CVD according to SCORE2-OP (n = 361). The achievement of low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG) levels, as well as the use of evidence-based medications recommended by disease-specific treatment guidelines, were assessed. Logistic regression analysis was used to explore sex differences in achieving national treatment targets.

Results

In the secondary prevention of CVD, more men than women achieved the treatment target levels for LDL-C (38% vs. 25%, respectively) (OR 1.82, 95% CI 1.07–3.11), SBP (18% vs. 9%) (OR 2.24, 95% CI 1.05–4.79), and DBP (41% vs. 30%) (OR 1.69, 95% CI 1.01–2.82). Additionally, men were more likely than women to use lipid-lowering (82% vs. 70%) (OR 1.95, 95% CI 1.08–3.49) and diabetes (27% vs. 14%) (OR 2.16, 95% CI 1.15–4.05) medications. Among those using antihypertensives, men were more likely than women to meet the treatment target levels for SBP (19% vs. 9%) (OR 2.36, 95% CI 1.03–5.43) and DBP (43% vs. 30%) (OR 1.78, 95% CI 1.01–3.13). In the primary prevention of CVD, the only significant sex differences were observed in the use of antihypertensive medications: men were less likely than women to use agents acting on the renin-angiotensin system (45% vs. 62%) (OR 0.49, 95% CI 0.32–0.74) or any antihypertensive medications (57% vs. 74%) (OR 0.46, 95% CI 0.29–0.72).

Conclusions

In primary care, there is a need for improvements in both secondary and primary prevention of CVDs in older adults, particularly in addressing elevated SBP and LDL-C levels. Moreover, the insufficient treatment of women in secondary prevention is a significant concern.

Trial registration

ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.