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Differences based on patient gender in the management of hypertension: a multilevel analysis

Journal of Human Hypertension volume 35, pages 1109–1117 (2021)Cite this article

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Abstract

The objective of our study was to investigate differences in the management of men and women treated for hypertension while considering the gender of their physicians. We used the data from the cross-sectional Paris Prevention in General Practice survey, where 59 randomly recruited general practitioners (42 men and 19 women) from the Paris metropolitan area enroled every patient aged 25–79 years taking antihypertensive medication and seen during a 2-week period (520 men and 666 women) in 2005–6. The presence in the medical files of six items recommended for hypertension management (blood pressure measurement, smoking status, cholesterol, creatinine, fasting blood glucose and electrocardiogram) was analysed with mixed models with random intercepts and adjusted for patient and physician characteristics. We found that the presence of all items was lower in the records of female than male patients (3.9 vs. 6.9%, p = 0.01), as was the percentage of items present (58.5 vs. 64.2%, p = 0.003). The latter gender difference was substantially more marked when the physician was a man (69.3 vs. 63.4%, p = 0.0002) rather than a woman (63.5 vs. 61.0%, p = 0.46). Although all guidelines recommend the same management for both genders, the practices of male physicians in hypertension management appear to differ according to patient gender although those of women doctors do not. Male physicians must be made aware of how their gender influences their practices.

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The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors are extremely grateful to all the patients and GPs who took part in this study and the entire Paris Prevention in General Practice team.

Funding

The Paris Prevention in General Practice received financial support from the French National Institute of Health and Medical Research (Inserm), the National Health Insurance Fund for Employees (CNAMTS), the French Health Authority (HAS), the Directorate for Research, Studies, Evaluation and Statistics (Drees), the Interministerial Mission on Research (MIRE), the National Public Health Research Institute (IReSP), the French Institute of Health Prevention and Education (Inpes) and the Fondation de France.

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Authors and Affiliations

  1. Université Paris-Saclay, Univ. Paris-Sud, Département de Médecine Générale, 94270, Le Kremlin-Bicêtre, France

    Colinne Patrice, Raphaëlle Delpech & Laurent Rigal

  2. Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France

    Colinne Patrice, Raphaëlle Delpech, Henri Panjo, Virginie Ringa & Laurent Rigal

  3. Institut national d’études démographiques (INED), F-75020, Paris, France

    Colinne Patrice, Raphaëlle Delpech, Henri Panjo, Virginie Ringa & Laurent Rigal

  4. Société de Formation Thérapeutique du Généraliste (SFTG), Paris, France

    Hector Falcoff

  5. Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France

    Marie-Josèphe Saurel-Cubizolles

Authors
  1. Colinne Patrice
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Correspondence to Colinne Patrice.

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Supplementary information

41371_2020_450_MOESM1_ESM.docx

Supplementary Table 1. Patient gender differences in medical management of hypertension according to their cardiovascular risk level (n=1141)

41371_2020_450_MOESM2_ESM.docx

Supplementary Table 2. Patient gender differences in medical management of hypertension in patients with or without known diabetes (n=1141)

41371_2020_450_MOESM3_ESM.docx

Supplementary Table 3. Patient gender differences in medical management of hypertension according to their blood pressure level (n=1114)

41371_2020_450_MOESM4_ESM.docx

Supplementary Table 4. Patient gender differences in medical management of hypertension according to general practitioners’ gender and patients’ cardiovascular risk level (n=1141)

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Patrice, C., Delpech, R., Panjo, H. et al. Differences based on patient gender in the management of hypertension: a multilevel analysis. J Hum Hypertens 35, 1109–1117 (2021). https://doi.org/10.1038/s41371-020-00450-y

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