Retrospective review of sex differences in the management of dyslipidemia in coronary heart disease: an analysis of patient data from a Maryland-based health maintenance organization.


BACKGROUND:Coronary heart disease (CHD) is the leading cause of death in men and women in the United States, with a higher mortality in women, despite a lower prevalence. Statins effectively treat dyslipidemia and reduce the risk of CHD mortality. OBJECTIVE:The objective of this study was to evaluate the treatment of dyslipidemia in patients with CHD and determine if sex differences exist. METHODS:This was a retrospective chart review performed within a multioffice staff model health maintenance organization of approximately 70,000 members. An administrative database, containing inpatient and out-patient medical claims, was used to identify patients with CHD based on diagnostic codes. Charts were randomly selected and the following information was obtained from chart review: age; sex; risk factors for CHD; diagnosis and/or prescription for depression; blood low-density lipoprotein cholesterol (LDL-C) level; and drug, dosage, and duration of prescribed lipid-lowering therapy. Exclusion criteria included missing charts and unavailable LDL-C values. LDL-C values were classified as at target if LDL-C<2.59 mmol/L (<100 mg/dL). Patients receiving statin monotherapy were categorized into 3 potency groups, based on efficacy to lower LDL-C values: high (atorvastatin 20-80 mg, lovastatin 80 mg), medium (atorvastatin 10 mg, pravastatin 40 mg, simvastatin 200 mg), and low (fluvastatin 10-40 mg, lovastatin 10-40 mg, pravastatin 10-20 mg, simvastatin 5-10 mg). RESULTS:A total of 1487 adult patients (64.4% male with a mean (SD) age of 65.7 (11.8) years were identified, based on diagnostic codes for CHD. Three hundred twenty charts were selected for review. After exclusion, the final study cohort was 290 patients. The cohort was 66.2% male (192/290) with no significant difference in mean (SD) age between men (65.2 [9.2] years) and women (66.9 [10.5] years). Weight of women ranged from 85 to 305 lbs; 134 to 288 lbs for men. Among the study cohort, 46.2% (134/290) of the patients achieved the target LDL-C of <2.59 mmol/L (<100 mg/dL), with significantly more men (51.0% [98/192]) than women (36.7% [36/98]) reaching target (P=0.021). Lipid-lowering therapy was prescribed to 68.6% (199/290) of the patients, with no significant sex differences (men, 71.4% [137/192]; women, 63.3% [62/98]). Of the patients prescribed lipid-lowering therapy (primarily statins), 53.8% (107/199) achieved target LDL-C. There was no significant sex difference in the potency groups prescribed, and the rate of LDL-C target attainment was similar across potency groups. Overall, 70.3% of patients who did not receive lipid-lowering therapy had inadequately controlled LDL-C (women, 31/36 [86.1%]; men, 33/55 [60.0%] [P=0.008]). CONCLUSIONS:The majority of CHD patients from a Maryland-based health maintenance organization had elevated LDL-C values, despite a lipid-lowering prescription rate of 68.6%. A significant gap in dyslipidemia treatment in these CHD patients remained, particularly for women.


Clin Ther


Clinical therapeutics


Cooke CE,Hammerash WJ Jr




Has Abstract


2006-04-01 00:00:00














  • Efficacy of Fluoroquinolone/Probiotic Combination Therapy for Recurrent Urinary Tract Infection in Children: A Retrospective Analysis.

    abstract:PURPOSE:Children with normal urinary tract anatomy and function and highly recurrent urinary tract infection (rUTI) may have a lack of alternatives when antibiotic prophylaxis and "watchful waiting" approaches fail. This retrospective review reports the outcomes in children who received a fluoroquinolone/probiotic comb...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Madden-Fuentes RJ,Arshad M,Ross SS,Seed PC

    更新日期:2015-09-01 00:00:00

  • Efficacy and safety of morning versus evening dose of controlled-release simvastatin tablets in patients with hyperlipidemia: a randomized, double-blind, multicenter phase III trial.

    abstract:BACKGROUND:Flexibility in the recommended dosing time for a statin may improve patient compliance. OBJECTIVE:This study was designed to compare the efficacy and tolerability of morning and evening doses of controlled-release simvastatin in Korean adults with dyslipidemia. It was carried out as a requirement to obtain ...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Kim SH,Kim MK,Seo HS,Hyun MS,Han KR,Cho SW,Kim YK,Hoon Park S

    更新日期:2013-09-01 00:00:00

  • Relative Bioavailability of Methylphenidate Extended-release Chewable Tablets Chewed Versus Swallowed Whole.

    abstract:PURPOSE:Methylphenidate hydrochloride extended-release chewable tablet (MPH ERCT) is approved for treatment of attention deficit hyperactivity disorder in patients aged 6 years and older. This article evaluates the pharmacokinetic parameters and relative bioavailability of MPH ERCT when chewed versus swallowed whole. ...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Abbas R,Childress AC,Nagraj P,Rolke R,Berry SA,Palumbo DR

    更新日期:2018-05-01 00:00:00

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    abstract::The Omnibus Budget Reconciliation Act of 1990 (OBRA-90) may be the most significant piece of legislation affecting the practice of pharmacy since the Durham-Humphrey amendments to the Food, Drug and Cosmetic Act. As part of the OBRA-90 legislation, the Health Care Financing Administration (HCFA) was required to publis...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Nightengale B,Reeder CE

    更新日期:1993-05-01 00:00:00

  • Long-acting insulin analogues and diabetic retinopathy: a retrospective cohort study.

    abstract:PURPOSE:Long-acting insulin analogues were developed to facilitate consistent glycemic control without excessive hypoglycemia. However, structural modifications of the insulin molecule can alter biological responses and binding characteristics with specific receptors. The aim of this study was to estimate the risk of s...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Lin JC,Shau WY,Lai MS

    更新日期:2014-09-01 00:00:00

  • Anemia and thrombocytopenia in patients undergoing chemotherapy for solid tumors: a descriptive study of a large outpatient oncology practice database, 2000-2007.

    abstract:OBJECTIVE:This study was conducted to evaluate data on chemotherapy-associated anemia and thrombocytopenia, and cycle delays in patients with cancer in a community oncology practice. METHODS:Data on adult patients (age > or =18 years) with cancer treated in outpatient oncology clinics throughout the United States betw...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,多中心研究


    authors: Wu Y,Aravind S,Ranganathan G,Martin A,Nalysnyk L

    更新日期:2009-01-01 00:00:00

  • Prevalence, utilization patterns, and predictors of antipsychotic polypharmacy: experience in a multistate Medicaid population, 1998-2003.

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Morrato EH,Dodd S,Oderda G,Haxby DG,Allen R,Valuck RJ

    更新日期:2007-01-01 00:00:00

  • Twenty-eight-day oral contraceptives: physician and user attitudes.

    abstract::A 28-day regimen of oral contraceptives that uses seven iron tablets (each containing 75 mg of ferrous fumarate) instead of seven sugar placebos was designed to encourage user compliance. To determine professional and user attitudes toward the 28-day regimen, 192 obstetrician-gynecologists and 469 women who used oral ...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Richards-Brandt M

    更新日期:1988-01-01 00:00:00

  • Comparison of propofol, droperidol, and metoclopramide for prophylaxis of postoperative nausea and vomiting after breast cancer surgery: a prospective, randomized, double-blind, placebo-controlled study in Japanese patients.

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验,收录出版


    authors: Fujii Y,Itakura M

    更新日期:2008-11-01 00:00:00

  • Ambrisentan for the management of pulmonary arterial hypertension.

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Cheng JW

    更新日期:2008-05-01 00:00:00

  • Comparative Bioavailability of Hydroxyprogesterone Caproate Administered via Intramuscular Injection or Subcutaneous Autoinjector in Healthy Postmenopausal Women: A Randomized, Parallel Group, Open-label Study.

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Krop J,Kramer WG

    更新日期:2017-12-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Lipsky BA,Unowsky J,Zhang H,Townsend L,Talbot GH

    更新日期:1999-06-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Liu Y,Qiu T,Liu Y,Wang J,Hu K,Bao F,Zhang C

    更新日期:2019-06-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Mesquita Mdo C,Sol EB,Malarme M,Noubouossie D,Demulder AC

    更新日期:2009-11-01 00:00:00

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    pub_type: 杂志文章


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    更新日期:2011-11-01 00:00:00

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    pub_type: 杂志文章,随机对照试验


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    更新日期:2020-08-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Rodriguez KM

    更新日期:2013-02-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验


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    更新日期:2016-03-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Hakim Z,Kucukarslan S

    更新日期:1993-03-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Nakagawa K,Aoki Y,Kusama T,Ban N,Nakagawa S,Sasaki Y

    更新日期:1997-07-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章


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    更新日期:2020-11-24 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Lockie LM

    更新日期:1986-01-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Villavicencio JC,McHugh KW,Edmonds BT

    更新日期:2020-03-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Burris JF

    更新日期:1993-05-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Pearlman DS,Lampl KL,Dowling PJ Jr,Miller CJ,Bonuccelli CM

    更新日期:2000-06-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Schellekens H

    更新日期:2002-11-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验


    authors: Shakeri-Nejad K,Aslanis V,Veldandi UK,Mooney L,Pezous N,Brendani B,Juan A,Allison M,Perry R,Legangneux E

    更新日期:2015-11-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Sweany AE,Shapiro DR,Tate AC,Goldberg RB,Stein EA

    更新日期:1995-03-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Finnell JT,Twillman RK,Breslan SA,Schultz J,Miller L

    更新日期:2017-09-01 00:00:00

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    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Glasser SP,Ripa SR,Allenby KS,Schwartz LA,Commins BM,Jungerwirth S

    更新日期:1995-03-01 00:00:00