02743nas a2200217   4500000000100000008004100001100001900042700001900061700001400080700001400094700001600108700001800124700001900142700001600161700001700177700001800194245011500212300001200327490000700339520217900346       2011                            d1 aArima Hisatomi1 aTurnbull Fiona1 aCass Alan1 aWeekes A.1 aHeeley Emma1 aMorgan Claire1 aAnderson Craig1 aChalmers J.1 aPeiris David1 aPatel Anushka00aGender disparities in the assessment and management of cardiovascular risk in primary care: the AusHEART study  a498-5030 v183 a<p>
Aims: Studies indicate ongoing gender-based differences in the prevention, detection and management of cardiovascular disease. The aims of this study were to determine whether there are differences in general practitioners’ (GPs’) perceptions of a patient’s cardiovascular risk compared with the patient’s estimated risk and in the patient’s subsequent medical management according to patient sex.Methods: The Australian Hypertension and Absolute Risk Study (AusHEART) was a nationally representative, cluster-stratified, cross-sectional survey among 322 GPs. Each GP was asked to collect data on cardiovascular disease risk factors and their management in 15–20 consecutive patients (age ≥55 years) who presented between April and June, 2008. They were also asked to estimate each patient’s absolute risk of a cardiovascular event in the next five years. The main outcomes were the Adjusted Framingham risk, GP estimated risk and proportion of patients receiving blood pressure-lowering, statin and antiplatelet therapy.Results: A total of 5293 patients were recruited to the study, of whom 2968 (56%) were women. Among patients without established cardiovascular disease, the level of agreement between the GP estimated risk and the Adjusted Framingham risk was poor (&lt;50%) and was similarly so for men (kappa coefficient 0.18; 95% confidence interval (CI) 0.14–0.21) and women (0.19; 95% CI 0.16–0.22; P homogeneity = 0.57). For patients with established cardiovascular disease, however, women were more likely to be assigned by the GP to a lower risk category (66% vs. 54%, P &lt; 0.001) and less likely to be prescribed combination (blood pressure-lowering, statin and antiplatelet) (44% vs. 56%, P &lt; 0.001) therapy compared with men, even after adjusting for patient age.Conclusions: Cardiovascular risk is underrecognized and undertreated in Australian primary care patients, with women apparently disproportionately affected. These findings underscore the importance of initiatives to raise awareness of cardiovascular disease in women.
</p>