Gender Differences in the Management of Diabetic Patients with Hypertension and Chronic Ischemic Heart Disease

Abstract

Objective: To determine gender differences in cardiovascular risk factors control and clinical management in hypertensive diabetics with chronic ischemic heart disease. Research design and methods: CINHTIA was a cross-sectional and multicenter survey aimed to evaluate the clinical profile and management of hypertensive outpatients with chronic ischemic heart disease attended by cardiologists in Spanish clinical practice setting. The aim of the present work was to examine the gender differences in the control and treatment of cardiovascular risk factors in the subgroup of patients with diabetes. Adequate blood pressure (BP), LDL-cholesterol and diabetes control rates were defined according to ESH-ESC 2003, NCEP-ATP III and ADA-2005 guidelines, respectively. Results: A total of 654 patients (42.4% women) were included for the present analysis. Women were older. Smoking, sed- entary lifestyle and peripheral arterial disease were more frequent in men; left ventricular hypertrophy and heart failure in women. The total number of lipid lowering and antihypertensive agents were similar between genders, but with a trend to use more antidiabetic drugs in women. There was a tendency to a better BP control in men (21.5% vs 17.0%, p=0.09). LDL-cholesterol and diabetes were better controlled in men (34.6% vs 26.6%, p=0.04 and 29.7% vs 22.3%, p=0.025, re- spectively). Conclusions: Diabetic women with hypertension and chronic ischemic heart disease exhibit lower control rates of cardio- vascular risk factors.