Abstract 10046: Sex Differences in Risk Factors, Perceived Risk, and Healthcare Provider Discussion of Risk and Risk Modification among Young Patients with Acute Myocardial Infarction: The VIRGO Study

Abstract

Background: Prevention, detection, and treatment of cardiovascular (CV) risk factors require that individuals are educated about their CV risk, perceive themselves to be at risk, and are given guidance on risk modification. As a foundation for future interventions, we sought to describe risk factor prevalence and perceptions of CV risk among young patients hospitalized with MI.

Methods: The VIRGO study enrolled 2990 patients with MI aged 18-55y from 104 US hospitals between 8/21/08-1/5/12 (67% women). Using Pearson χ² tests and modified Poisson regression with robust error variance, we compared the prevalence of 5 CV risk factors by sex and compared self-perceived risk for heart disease and self-reported provider discussion of risk/risk modification before their MI by sex and within risk factor subgroups.

Results: Nearly all women (97%) and men (99%) had at least 1 risk factor, and 69% of women and 64% of men had ≥3 (Figure 1A). Women were significantly more likely to have diabetes and be obese, while men were more likely to have dyslipidemia; hypertension and smoking did not differ markedly by sex. Prior to their MI, only a moderate proportion of women and men considered themselves at risk for heart disease (55% and 59%, respectively) or had a provider tell them they were at risk (49% and 53%). Women were less likely than men to report that a provider talked to them about heart disease and ways to modify their risk prior to MI (50% vs 60%, p<.001), and this relationship persisted after adjusting for sociodemographic characteristics, healthcare access, and risk factors (RR 0.84, 95% CI 0.79-0.89). The relationship was also evident across risk factor subgroups (Figure 1B).

Conclusion: Traditional CV risk factors are highly prevalent in young patients with MI. Women had a greater risk factor burden than men, yet they were less likely to report that their healthcare providers talked to them about heart disease or provided them guidance on ways to modify their risk prior to their MI.