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  • 1
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: Statin utilization for LDL-C lowering remains the cornerstone management strategy to reduce the risk of ASCVD. While lower statin utilization has been reported among women compared to men, contemporary studies evaluating sex disparities in LDL-C management across the spectrum of ASCVD are lacking, particularly across age and racial/ethnic subgroups. We aimed to provide detailed insights into this using data from a large US healthcare system. Methods: Cross-sectional study using data from ∼1.1 million patients aged 18+ years in the Houston Methodist Learning Health System Registry (2016-2022). Prevalent ASCVD including CAD, PAD, and stroke were identified using ICD 10-CM codes. Statin use and dose were identified in the database using ATC codes, and this information was recorded based on medication reconciliation reviews with patients at each clinical encounter. Individuals (n=973,720) without established ASCVD were excluded. Results: The study population consisted of 97,819 patients with prevalent ASCVD (55% men; 45% women, mean age: 69 years, 19% NHB, 12% Hispanic). Women with ASCVD reported lower statin use (64.3% vs 72.6%) and lower high-intensity statin use (29.8% vs 42.5%) compared with men. Women were also less likely to have on-treatment LDL-C 〈 70, and this was true for total ASCVD (21.8% vs 30.6%), CAD (24.9% vs 32.9%), PAD (23.2% vs 32.6%), and stroke (20.9% vs 30.1%). These disparities persisted across age ( 〈 45, 45-64, 〉 65 years) and racial/ethnic (NHW, Hispanics, NHB, Asian/Other) strata. Conclusion: Significant gender disparities exist in contemporary LDL-C management among US patients with ASCVD, with women being less likely to receive any and high-intensity statin therapy, and reach the guideline defined goal of LDL-C 〈 70 mg/dL than men across age and racial/ethnic subgroups. These disparities underscore the need for further research to understand their drivers, and targeted systemwide programs to overcome care gaps.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 2
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. Suppl_1 ( 2022-03)
    Abstract: Introduction: Area Deprivation Index (ADI), a proxy measure for neighbourhood socioeconomic context, is informative for prioritizing limited resources in improving health outcomes. With emerging therapeutic options to improve cardiometabolic health among individuals with morbid obesity, whether available measures, such as ADI, for integrated health systems can identify this subpopulation at risk is unknown. Methods: This cross-sectional study analyzed data from 865,995 adult patients in the Houston Methodist Outpatient Learning Health System Registry between June 1 st , 2016 and July 20 th , 2021. Using University of Wisconsin-Madison School of Medicine’s ADI dataset, each patient was assigned an ADI rank according to the census block group of their geocoded residential address. BMI was calculated based on recorded height and weight. Patients with non-geocoded addresses (n=9 855), missing and abnormal BMI values (n=107 037) were excluded. Multinomial logistic regression models were used to examine the association between ADI and morbid obesity (BMI≥40 kg/m 2 ). Results: A total of 751,174 adults with an ADI ranking were included in the analysis. Overall, the prevalence of morbid obesity was 6.9% (n=51,609). The age-adjusted prevalence of morbid obesity increased across worsening neighborhood deprivation in overall population and across racial/ethnic subgroups (Figure 1). Each ADI rank increase in neighborhood disadvantage was associated with an unadjusted odds ratio (OR) of 1.022 (95% CI, 1.022-1.023) for morbid obesity compared to normal weight. After adjusting for age, sex and race/ethnicity, we found a statistically significant association of worst vs least level of neighborhood deprivation with patients with morbid obesity compared to normal weight (aOR, 3.75; 95% CI, 3.60-3.89). Conclusion: The study highlights utility of census-based measures to identify patients living in socioeconomically deprived areas for comprehensive morbid obesity management strategies.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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