Influence of Socioeconomic Gender Inequality on Sex Disparities in Prevention and Outcome of Cardiovascular Disease: Data From a Nationwide Population Cohort in China

作者：Yunfeng Wang, Aoxi Tian, Chaoqun Wu, Jiapeng Lu, Bowang Chen, Yang Yang, Xiaoyan Zhang, Xingyi Zhang, Jianlan Cui, Wei Xu, Lijuan Song, Weihong Guo, Runsi Wang, Xi Li, Shengshou Hu · 发表于：Journal of the American Heart Association · 年份：2023 · DOI：10.1161/jaha.123.030203 · 被引用次数：5 · 研究领域：Sex and Gender in Healthcare、Global Public Health Policies and Epidemiology

Background Knowledge gaps remain in how gender‐related socioeconomic inequality affects sex disparities in cardiovascular diseases (CVD) prevention and outcome. Methods and Results Based on a nationwide population cohort, we enrolled 3 737 036 residents aged 35 to 75 years (2014–2021). Age‐standardized sex differences and the effect of gender‐related socioeconomic inequality (Gender Inequality Index) on sex disparities were explored in 9 CVD prevention indicators. Compared with men, women had seemingly better primary prevention (aspirin usage: relative risk [RR], 1.24 [95% CI, 1.18–1.31] and statin usage: RR, 1.48 [95% CI, 1.39–1.57]); however, women's status became insignificant or even worse when adjusted for metabolic factors. In secondary prevention, the sex disparities in usage of aspirin (RR, 0.65 [95% CI, 0.63–0.68]) and statin (RR, 0.63 [95% CI, 0.61–0.66]) were explicitly larger than disparities in usage of angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers (RR, 0.88 [95% CI, 0.84–0.91]) or β blockers (RR, 0.67 [95% CI, 0.63–0.71]). Nevertheless, women had better hypertension awareness (RR, 1.09 [95% CI, 1.09–1.10]), similar hypertension control (RR, 1.01 [95% CI, 1.00–1.02]), and lower CVD mortality (hazard ratio, 0.46 [95% CI, 0.45–0.47]). Heterogeneities of sex disparities existed across all subgroups. Significant correlations existed between regional Gender Inequality Index values and sex disparities in usage of angiotensin‐converting enzyme i...