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Randomized Controlled Trial
. 2009 Mar;11(3):299-303.
doi: 10.1093/eurjhf/hfn041. Epub 2009 Jan 21.

Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure in a cross-sectional study

Magnus Baumhäkel  1 , Ulrike Müller, Michael Böhm
Affiliations
Randomized Controlled Trial

Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure in a cross-sectional study

Magnus Baumhäkel et al. Eur J Heart Fail. 2009 Mar.

Abstract

Aims: Clinical outcomes of patients with chronic heart failure (CHF) have improved, but evidence-based treatment appears to be imbalanced depending on patients' and physicians' gender. We aimed to determine the interactions of gender with medical treatment of CHF.

Methods and results: Consecutive patients with CHF (n = 1857) were evaluated regarding co-morbidities, New York Heart Association classification, current medical treatment, and dosage of angiotensin-converting enzyme-inhibitors (ACE-Is) and beta-blockers. Gender of patients and treating physicians was recorded. Baseline characteristics of patients and physicians were comparable for males and females. Female patients were less frequently treated with ACE-Is, angiotensin-receptor blockers, or beta-blockers. Achieved doses were lower in female compared with male patients. Guideline-recommended drug use and achieved target doses tended to be higher in patients treated by female physicians. There was no different treatment for male or female patients by female physicians, whereas male physicians used significantly less medication and lower doses in female patients. In multivariable analysis, female gender of physicians was an independent predictor of use of beta-blockers.

Conclusion: Treatment of CHF is influenced by patients', but also physicians' gender with regard to evidenced-based drugs and their dosage. Physicians should be aware of this problem in order to avoid gender-related treatment imbalances.

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Figures

Figure 1
Figure 1
Gender-specific treatment of chronic heart failure. Left, differences in use of angiotensin-converting enzyme-inhibitors (ACE-Is)/angiotensin-receptor blockers (upper left panel) or beta-blockers (lower left panel) according to the gender of patient and physician. Right: percentage of patients receiving at least 75% of recommended dose of ACE-Is (upper right panel) or beta-blockers (lower right panel) according to the gender of patient and physician. MD, medical doctor.
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