Women Less Likely to Receive Guideline-Recommended Medications Following Stroke

After stroke, men and women receive differing poststroke prevention medications, according to results of a study published in Stroke.

Previous studies have found that women were less likely to receive hyperacute therapies, early mobilization interventions, and secondary preventative medications than men after stroke.

Investigators from the School of Clinical Sciences at Monash Health in Australia sourced data for this population-based retrospective cohort study from PRECISE, which contains person-level data from the Australian Stroke Clinical Registry (AuSCR). Patients (N=18,452) with first-ever stroke or transient ischemic attack between 2012 and 2016 who survived to 60 days were evaluated for secondary prevention medication receipt on the basis of gender.

The men (n=10,344) and women (n=8108) had median ages of 70.5 (IQR, 60.6-79.1) and 74.3 (IQR, 62.7-82.7) years (P <.001), 64.4% and 60.1% had ischemic stroke (P <.001), and they had a medial hospital frailty risk score of 7.1 (IQR, 3.7-12.2) and 8.0 (IQR, 4.1-14.3) points (P <.001), respectively.

Women were less likely to be prescribed antihypertensive medications at discharge (adjusted odds ratio [aOR], 0.82; 95% CI, 0.74-0.91) or to initiate antihypertensive medications (aOR, 0.76; 95% CI, 0.69-0.84) but not to discontinue antihypertensive medications (aOR, 0.97; 95% CI, 0.88-1.07) compared with men.

Women were less likely to initiate antithrombotic medications than men (aOR, 0.89; 95% CI, 0.82-0.96) but were similarly as likely to receive an antithrombotic medication prescription at discharge (aOR, 0.98; 95% CI, 0.84-1.14) or to discontinue antithrombotic medications (aOR, 0.97; 95% CI, 0.90-1.06).

No significant gender-based prescription, initiation, or discontinuation trends were observed for lipid-lowering medication.

Among women, significant age-specific trends were observed for prescription of antihypertensive medication (P <.001), initiation of antihypertensive (P <.001) or antithrombotic (P =.008) medications, and discontinuation of all 3 drug classes (all P £.002). Older women were more likely and younger women less likely to be prescribed antihypertensive medications, initiation of antihypertensive medications peaked between 70 and 90 years of age, initiation of antithrombotic medications was highest for younger women, and medication discontinuation rates were highest for both younger and older women relative to men.

This study was limited by using medication dispensations as a proxy for initiation.

The study authors concluded, “We identified differences between men and women in the prescription, initiation, and discontinuation of guideline-recommended medications following stroke. Many of these sex differences were observed for women in the youngest and oldest age groups, highlighting important subpopulations of patients who may benefit from more rigorous risk factor modification poststroke.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on The Cardiology Advisor