According to a study published in JAMA Cardiology.
The researchers sought to explore the association of sex with domains of physical and mental health, as well as access to health care, among adults with self-reported premature ASCVD. The researchers conducted a retrospective analysis between 2016 and 2019 using data from adults enrolled in the US Behavioral Risk Factor Surveillance System (BRFSS) survey. Participants aged 18 to 55 years were identified through the BRFSS. All relevant data was examined from June to July 2021. In this analysis, self-reported ASCVD was defined as “having a history of coronary artery disease, myocardial infarction, or stroke.” The main outcome measures of the study were self-reported physical and mental health, along with measures of access to care, which included self-reported cost-associated medication nonadherence and inability to see a doctor because of cost.
Among 748,090 adults ages 18 to 55 who were identified between 2016 and 2019, a total of 28,522 had self-reported premature ASCVD. Overall, 47.0% of those identified were women. After multivariate logistic regression analysis, women versus men with premature ASCVD were significantly more likely to report poor overall physical health (odds ratio [OR], 1.39; 95% CI, 1.09 to 1.78; P =.008), clinical depression (OR, 1.73; 95% CI, 1.41 to 2.14; P <.001), cost-related medication nonadherence (OR, 1.42; 95% CI, 1.11 to 1.82; P =.005), and not being able to see a doctor because of cost (OR, 4.52; 95% CI, 2.24 to 9.13; P <.001).
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These findings occurred despite the fact that women were statistically significantly more likely than men to have health care coverage (85.3% vs. 80.8%, respectively; P =.04) and having a primary care physician (84.2% vs 75.7%, respectively; P <.001).
The researchers concluded that the results of the current study show that interventions designed to address mental health and out-of-pocket costs are greatly needed in the adult patient population with ASCVD.
“These findings underscore the importance of reducing cardiovascular disparities by encouraging policy-level efforts that advocate the integration of social determinants of health into existing clinical delivery support systems and promote investments in the development of assessment of social risks that allow clinicians to specifically target this vulnerable population. the study authors noted. “Ultimately, our results highlight the need for policy-level interventions to address out-of-pocket costs for this young patient population.”
Disclosure: Some of the study authors have disclosed affiliations with biotech, pharmaceutical, and/or device companies. See the original reference for a full list of authors’ statements.
Reference
Jain V, Al Rifai M, Turpin R, et al. Assessing Factors Underlying Sex-Based Disparities in Cardiovascular Care in Adults With Self-Reported Premature Atherosclerotic Cardiovascular Disease. JAMA Cardiol. Published online January 5, 2022. doi:10.1001/jamacardio.2021.5430.
