Few sex differences in the use of drugs for secondary prevention after stroke: a nationwide observational study
Article first published online: 8 NOV 2011
Copyright © 2011 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 21, Issue 9, pages 911–919, September 2012
How to Cite
Sjölander, M., Eriksson, M. and Glader, E.-L. (2012), Few sex differences in the use of drugs for secondary prevention after stroke: a nationwide observational study. Pharmacoepidem. Drug Safe., 21: 911–919. doi: 10.1002/pds.2268
- Issue published online: 4 SEP 2012
- Article first published online: 8 NOV 2011
- Manuscript Accepted: 19 SEP 2011
- Manuscript Revised: 7 SEP 2011
- Manuscript Received: 10 JAN 2011
- Swedish Heart and Lung Foundation
- ischemic stroke;
- sex differences;
- secondary prevention;
- drug therapy;
This observational study describes the sex differences in the use of secondary preventive drugs after ischemic stroke in terms of prescribing and persistence. Also, sex differences in patient- and treatment-related factors associated with drug use were investigated.
In this nationwide register-based study, the Swedish Stroke Register was linked to the Swedish Prescribed Drug Register for information on drugs prescribed for, and bought by, stroke patients. Background factors were included from the Swedish Stroke Register.
Included in the database were 9331 men and 9018 women. Men were more often prescribed statins, 48.8% versus 38.1% [age-adjusted prevalence ratio (PR) = 0.86, 95%CI = 0.82–0.91], and warfarin, 38.4% versus 26.4% after stroke (age-adjusted PR = 0.88, 95%CI = 0.79–0.97). There were no differences in prescribing of antihypertensive or antiplatelet drugs. No sex differences were seen regarding not continuing drug treatment after discharge (primary non-adherence). Women had slightly higher persistence to antihypertensive treatment 2 years after discharge, 76.3% versus 71.9% for men (age-adjusted PR = 1.05, 95%CI = 1.00–1.09), but there were no differences in persistence to antiplatelet, warfarin or statin treatments. Similar factors were related to statin and warfarin prescribing for both men and women. Only antihypertensive treatment before stroke was associated to persistence to antihypertensive treatment, and this increased persistence for both men and women.
This study showed few differences between men and women after stroke. Patients' use of secondary preventive drugs needs to be improved, and from a public health perspective, poor persistence is probably a greater problem than differences between the sexes. Copyright © 2011 John Wiley & Sons, Ltd.