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Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy

BACKGROUND: This paper aims to assess the presence of gender differences in medication use and mortality in a cohort of patients affected exclusively by hypertension, in 193 municipalities in the Lombardy Region (Northern Italy), including Milan's metropolitan area. METHODS: A retrospective coh...

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Autores principales: Consolazio, David, Gattoni, Maria Elena, Russo, Antonio Giampiero
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013154/
https://www.ncbi.nlm.nih.gov/pubmed/35428215
http://dx.doi.org/10.1186/s12889-022-13052-9
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author Consolazio, David
Gattoni, Maria Elena
Russo, Antonio Giampiero
author_facet Consolazio, David
Gattoni, Maria Elena
Russo, Antonio Giampiero
author_sort Consolazio, David
collection PubMed
description BACKGROUND: This paper aims to assess the presence of gender differences in medication use and mortality in a cohort of patients affected exclusively by hypertension, in 193 municipalities in the Lombardy Region (Northern Italy), including Milan's metropolitan area. METHODS: A retrospective cohort study was conducted (N = 232,507) querying administrative healthcare data and the Register of Causes of Death. Hypertensive patients (55.4% women; 44.6% men) in 2017 were identified; gender differences in medication use (treatment, 80% compliance) and deaths (from all causes and CVDs) were assessed at two-year follow-ups in logistic regression models adjusted for age class, census-based deprivation index, nationality, and pre-existing health conditions. Models stratified by age, deprivation index, and therapeutic compliance were also tested. RESULTS: Overall, women had higher odds of being treated, but lower odds of therapeutic compliance, death from all causes, and death from CVDs. All the outcomes had clear sex differences across age classes, though not between different levels of deprivation. Comparing patients with medication adherence, women had lower odds of death from all causes than men (with a narrowing protective effect as age increased), while no gender differences emerged in non-compliant patients. CONCLUSIONS: Among hypertensive patients, gender differences in medication consumption and mortality have been found, but the extent to which these are attributable to a female socio-cultural disadvantage is questionable. The findings reached, with marked age-dependent effects in the outcomes investigated, suggest a prominent role for innate sex differences in biological susceptibility to the disease, whereby women would take advantage of the protective effects of their innate physiological characteristics, especially prior to the beginning of menopause. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-13052-9.
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spelling pubmed-90131542022-04-17 Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy Consolazio, David Gattoni, Maria Elena Russo, Antonio Giampiero BMC Public Health Research Article BACKGROUND: This paper aims to assess the presence of gender differences in medication use and mortality in a cohort of patients affected exclusively by hypertension, in 193 municipalities in the Lombardy Region (Northern Italy), including Milan's metropolitan area. METHODS: A retrospective cohort study was conducted (N = 232,507) querying administrative healthcare data and the Register of Causes of Death. Hypertensive patients (55.4% women; 44.6% men) in 2017 were identified; gender differences in medication use (treatment, 80% compliance) and deaths (from all causes and CVDs) were assessed at two-year follow-ups in logistic regression models adjusted for age class, census-based deprivation index, nationality, and pre-existing health conditions. Models stratified by age, deprivation index, and therapeutic compliance were also tested. RESULTS: Overall, women had higher odds of being treated, but lower odds of therapeutic compliance, death from all causes, and death from CVDs. All the outcomes had clear sex differences across age classes, though not between different levels of deprivation. Comparing patients with medication adherence, women had lower odds of death from all causes than men (with a narrowing protective effect as age increased), while no gender differences emerged in non-compliant patients. CONCLUSIONS: Among hypertensive patients, gender differences in medication consumption and mortality have been found, but the extent to which these are attributable to a female socio-cultural disadvantage is questionable. The findings reached, with marked age-dependent effects in the outcomes investigated, suggest a prominent role for innate sex differences in biological susceptibility to the disease, whereby women would take advantage of the protective effects of their innate physiological characteristics, especially prior to the beginning of menopause. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-13052-9. BioMed Central 2022-04-15 /pmc/articles/PMC9013154/ /pubmed/35428215 http://dx.doi.org/10.1186/s12889-022-13052-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Consolazio, David
Gattoni, Maria Elena
Russo, Antonio Giampiero
Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy
title Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy
title_full Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy
title_fullStr Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy
title_full_unstemmed Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy
title_short Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy
title_sort exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in northern italy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013154/
https://www.ncbi.nlm.nih.gov/pubmed/35428215
http://dx.doi.org/10.1186/s12889-022-13052-9
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