Association of physician's sex with risk factor control in treated hypertensive patients from Swedish primary healthcare

J Hypertens. 2008 Oct;26(10):2050-2056. Journath G, Hellénius ML, Manhem K, Kjellgren KI, Nilsson PM; for the Hyper-Q Study Group, Sweden. aDepartment of Medicine, Clinical Epidemiology unit, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden bMerck Sharp & Dohme (Sweden) AB, Sollentuna, Sweden cSahlgrenska University Hospital/Ostra, Sweden dSahlgrenska Academy, Gothenburg University, Gothenburg, Sweden eDepartment of Clinical Sciences, Lund University, University Hospital, Malmö, Sweden.

OBJECTIVE: To study the association of physician's sex with blood pressure, lipid control, and cardiovascular risk factors in treated hypertensive men and women, stratified for the sex of their physician.

METHODS: In a cross-sectional survey of hypertensive patients, 264 primary care physicians (PCPs), 187 men and 77 women from across Sweden, recruited 6537 treated hypertensive patients (48% men) during 2002-2005, consecutively collected from medical records and registered on a web-based form connected to a central database. Patients were included consecutively in the same order as they visited the healthcare centre.

RESULTS: Hypertensive women more often reached target systolic/diastolic blood pressure levels (<140/90 mmHg) when treated by female PCPs than when they were treated by male PCPs (32 vs. 24%, P < 0.001). This difference remained when comparing female and male physicians' nondiabetic female patients. Both male and female patients had better control of total cholesterol and low-density lipoprotein cholesterol levels when treated by female PCPs than when treated by male PCPs (total cholesterol <5 mmol/l: women 30 vs. 24%, P < 0.001; men 42 vs. 34%, P < 0.001; low-density lipoprotein cholesterol <3 mmol/l: women 39 vs. 33%, P < 0.01; men 41 vs. 35%, P < 0.05). Female PCPs had a higher proportion of treated hypertensive patients with diabetes than did male PCPs but male PCPs had a higher prevalence of treated hypertensive men with microalbuminuria compared with female PCPs.

CONCLUSION: Female physicians appeared more often to reach the treatment goal for blood pressure in female patients and cholesterol levels in all patients than did male physicians.




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