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Race-sex differences in the management of hyperlipidemia: the REasons for Geographic and Racial Differences in Stroke study.

ABSTRACT: Lipid management is less aggressive in blacks than whites and women than men.To examine whether differences in lipid management for race-sex groups compared to white men are due to factors influencing health services utilization or physician prescribing patterns.Because coronary heart disease (CHD) risk influences physician prescribing, Adult Treatment Panel III CHD risk categories were constructed using baseline data from REasons for Geographic And Racial Differences in Stroke study participants (recruited 2003-2007). Prevalence, awareness, treatment, and control of hyperlipidemia were examined for race-sex groups across CHD risk categories. Multivariable models conducted in 2013 estimated prevalence ratios adjusted for predisposing, enabling, and need factors influencing health services utilization.The analytic sample included 7,809 WM; 7,712 white women; 4,096 black men; and 6,594 black women. Except in the lowest risk group, black men were less aware of hyperlipidemia than others. A higher percentage of white men in the highest risk group was treated (83.2%) and controlled (72.8%) than others (treatment, 68.6%-72.1%; control, 52.2%-65.5%), with black women treated and controlled the least. These differences remained significant after adjustment for predisposing, enabling, and need factors. Stratified analyses demonstrated that treatment and control were lower for other race-sex groups relative to white men only in the highest risk category.Hyperlipidemia was more aggressively treated and controlled among white men compared with white women, black men, and especially black women among those at highest risk for CHD. These differences were not attributable to factors influencing health services utilization.

SUBMITTER: Safford MM

PROVIDER: S-EPMC4422177 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature

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Race-sex differences in the management of hyperlipidemia: the REasons for Geographic and Racial Differences in Stroke study.

Safford Monika M MM Gamboa Christopher M CM Durant Raegan W RW Brown Todd M TM Glasser Stephen P SP Shikany James M JM Zweifler Richard M RM Howard George G Muntner Paul P

American journal of preventive medicine 20150501 5

<h4>Background</h4>Lipid management is less aggressive in blacks than whites and women than men.<h4>Purpose</h4>To examine whether differences in lipid management for race-sex groups compared to white men are due to factors influencing health services utilization or physician prescribing patterns.<h4>Methods</h4>Because coronary heart disease (CHD) risk influences physician prescribing, Adult Treatment Panel III CHD risk categories were constructed using baseline data from REasons for Geographic ...[more]

PMID: 25891050

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Project description:Study objectivesTo examine the cross-sectional association between obstructive sleep apnea (OSA) risk and atrial fibrillation (AF) in the REasons for Geographic And Racial Differences in Stroke (REGARDS), a cohort of black and white adults.MethodsUsing REGARDS data from subjects recruited between 2003-2007, we assessed 20,351 participants for OSA status. High OSA risk was determined if the participant met at least two criteria from the Berlin Sleep Questionnaire (persistent snoring, frequent sleepiness, high blood pressure, or obesity). AF was defined as a self-reported history of a previous physician diagnosis or presence of AF on electrocardiogram. Logistic regression was used to determine odds ratio and 95% confidence interval for the association between OSA status and AF with subgroup analysis to examine effect modification by age, race, sex, and geographical region.ResultsThe prevalence of AF was 7% (n = 1,079/14,992) and 9% (n = 482/5,359) in participants at low and high risk of OSA, respectively (P < .0001). Persons at high risk of OSA had greater prevalence of diabetes and stroke history, and were more likely to be obese and taking sleep medications. In a multivariable analysis adjusted for demographics, cardiovascular risk factors, and potential confounders, high risk for OSA was associated with an increased odds of AF compared to low risk for OSA (odds ratio = 1.27, 95% confidence interval = 1.13, 1.44). This association differed significantly only by race (P for interaction = .0003). For blacks, there was a significant 58% increase in odds of AF in participants at high risk versus low risk of OSA, compared to a nonsignificant 12% increase in odds in whites. We were limited by self-reported variables, inability to adjust for obesity, and the cross-sectional nature of our study.ConclusionsHigh risk of OSA is associated with prevalent AF among blacks but not whites.CommentaryA commentary on this article appears in this issue on page 1459.

Dataset Information

Race-sex differences in the management of hyperlipidemia: the REasons for Geographic and Racial Differences in Stroke study.

Publications

Race-sex differences in the management of hyperlipidemia: the REasons for Geographic and Racial Differences in Stroke study.

Similar Datasets

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