Gender disparities in utilization of statins for low density lipoprotein management across the spectrum of atherosclerotic cardiovascular disease: Insights from the houston methodist cardiovascular disease learning health system registry

Shahid, Izza; Satish, Priyanka; Gullapelli, Rakesh; Nicholas, Juan C.; Javed, Zulqarnain; Avenatti, Eleonora; Bose, Budhaditya; Mahajan, Shiwani; Roy, Trisha; Sharma, Garima; Rodriguez, Fatima; Andrieni, Julia; Jones, Stephen L.; Al-Kindi, Sadeer; Cainzos-Achirica, Miguel; Nasir, Khurram

Gender disparities in utilization of statins for low density lipoprotein management across the spectrum of atherosclerotic cardiovascular disease: Insights from the houston methodist cardiovascular disease learning health system registry

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dc.contributor.author Shahid, Izza
dc.contributor.author Satish, Priyanka
dc.contributor.author Gullapelli, Rakesh
dc.contributor.author Nicholas, Juan C.
dc.contributor.author Javed, Zulqarnain
dc.contributor.author Avenatti, Eleonora
dc.contributor.author Bose, Budhaditya
dc.contributor.author Mahajan, Shiwani
dc.contributor.author Roy, Trisha
dc.contributor.author Sharma, Garima
dc.contributor.author Rodriguez, Fatima
dc.contributor.author Andrieni, Julia
dc.contributor.author Jones, Stephen L.
dc.contributor.author Al-Kindi, Sadeer
dc.contributor.author Cainzos-Achirica, Miguel
dc.contributor.author Nasir, Khurram
dc.date.accessioned 2025-10-06T06:25:53Z
dc.date.available 2025-10-06T06:25:53Z
dc.date.issued 2024
dc.description.abstract Introduction: Lower statin utilization is reported among women compared to men, however large-scale studies evaluating gender disparities in LDL-C management in individuals with ASCVD and its subtypes remain limited, particularly across age and racial/ethnic subgroups. In this study, we address this knowledge gap using data from a large US healthcare system. Methods: All adult patients with established ASCVD in the Houston Methodist Learning Health System Registry during 2016-2022 were included. Statin use and dose were extracted from the database. The association between gender and statin utilization was evaluated using multivariate logistic regression analyses in patients with ASCVD overall, across ASCVD subtypes, and by age, racial/ethnic subgroups, and socioeconomic risk factors. Results: A total of 97,819 patients with prevalent ASCVD were included. Women with ASCVD had lower utilization of any statin (64.3% vs 72.6 %; p < 0.001) and high-intensity statin (29.8% vs 42.5 % p < 0.001) compared with men. In fully adjusted models, women had 40 % lower odds of any (adjusted odds ratio [aOR]:0.58, 95 % CI 0.57-0.60) and high-intensity statin use (aOR:0.59, 0.57-0.61) relative to men. Women were also less likely to have guideline-recommended LDL-C < 70 mg/dL (30.2% vs 42.7 %; p < 0.01). These differences persisted across age, racial/ethnic and socioeconomic subgroups. Conclusion: Significant gender disparities exist in contemporary lipid management among patients with ASCVD, with women being less likely to receive any and high-intensity statin and achieving guideline defined LDL-C goal compared with men across age and racial/ethnic subgroups. These disparities underscore the need to further understand potential socioeconomic drivers of the observed lower statin uptake in women.
dc.format.mimetype application/pdf
dc.identifier.citation Shahid I, Satish P, Gullapelli R, Nicholas JC, Javed Z, Avenatti E, et al. Gender disparities in utilization of statins for low density lipoprotein management across the spectrum of atherosclerotic cardiovascular disease: Insights from the houston methodist cardiovascular disease learning health system registry. Am J Prev Cardiol. 2024 Aug 14;19:100722. DOI: 10.1016/j.ajpc.2024.100722
dc.identifier.doi http://dx.doi.org/10.1016/j.ajpc.2024.100722
dc.identifier.issn 2666-6677
dc.identifier.uri http://hdl.handle.net/10230/71387
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Am J Prev Cardiol. 2024 Aug 14;19:100722
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.keyword ASCVD
dc.subject.keyword Disparities
dc.subject.keyword Equity
dc.subject.keyword Gender
dc.subject.keyword Prevention
dc.subject.keyword Statin
dc.title Gender disparities in utilization of statins for low density lipoprotein management across the spectrum of atherosclerotic cardiovascular disease: Insights from the houston methodist cardiovascular disease learning health system registry
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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