American researchers reveal the reasons why treatment non-compliance after a stroke is more common in women than in men.
- After a stroke, women are less likely than men to take medication.
- A study shows that 80% of patients do not take prescribed cholesterol-lowering drugs and 53% do not use anticoagulants.
- This therapeutic non-compliance is partially due to the confounding effects of lifestyle, marital status and access to care.
“More women than men suffer from recurrent strokes. Therapeutic compliance (that is to say the way people comply with medical prescriptions or rules of treatment treatment program) is essential to prevent recurrence, but research examining gender differences is limited.” Faced with this observation, scientists from the School of Public Health at the University of Michigan (United States) decided to analyze the differences between men and women in terms of adherence to medications after a stroke, first overall and then by drug class.
Cholesterol: 80% of women do not take prescribed medications
In order to carry out the work, published in the journal Journal of the American Heart Associationthe authors identified, in a cohort, 1,324 adults who suffered a first stroke from 2008 to 2019. Among them, 48% were women and 58% were of Mexican origin. At 85 days after stroke, self-reported medication adherence was defined as never or rarely missing a dose within a week for each secondary stroke prevention treatment (antihypertensive, cholesterol-lowering, antiplatelet, anticoagulants). The team also took into account demographic and social factors, linked to the health system, lifestyle and state of health.
According to the data, women were more likely to report noncompliance with medications to prevent recurrences. In detail, 80% of them declare that they do not take prescribed cholesterol-lowering drugs and 53% do not use anticoagulants which could prevent a new stroke. The researchers found that women who were older, married or did not have private health insurance were more likely to not take their treatments on time.
“Less able to manage their own health” because women take care of “other family members”
If taking into account obesity has attenuated the differences between the sexes, that of age, family situation, access to care, smoking and alcohol consumption has only accentuate the differences between men and women. “Women in general, and Mexican American women in particular here, are more likely to care for other family members. As a result, they may be less able to set priorities and manage their own health”explained Chen Chenwho led the research.
According to Lynda Lisabeth, professor of epidemiology and neurology at the University of Michigan, clinicians should consider identifying these factors and discussing the importance of remembering doses when prescribing these medications to their patients. patients to reduce their risk of having another stroke.