Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults

Background We evaluated whether immigration status modified the association between sex and the quality of primary cardiovascular disease prevention in Ontario, Canada. Methods and Results We used a population‐based administrative database‐derived cohort of community‐dwelling adults (aged ≥40 years)...

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Autores principales:	Manav V. Vyas, Amy Y. X. Yu, Anna Chu, Bing Yu, Hibo Rijal, Jiming Fang, Peter C. Austin, Moira K. Kapral
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	cardiovascular immigration prevention quality sex Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/7345691d3e064b17931f4dce3e3ed8b6
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spelling	oai:doaj.org-article:7345691d3e064b17931f4dce3e3ed8b62021-11-16T10:22:43ZImmigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults10.1161/JAHA.121.0226352047-9980https://doaj.org/article/7345691d3e064b17931f4dce3e3ed8b62021-11-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.022635https://doaj.org/toc/2047-9980Background We evaluated whether immigration status modified the association between sex and the quality of primary cardiovascular disease prevention in Ontario, Canada. Methods and Results We used a population‐based administrative database‐derived cohort of community‐dwelling adults (aged ≥40 years) without prior cardiovascular disease residing in Ontario on January 1, 2011. In the preceding 3 years, we evaluated screening for hyperlipidemia and diabetes in those not previously diagnosed; diabetes control (HbA1c <7%); and medication use to control hypertension, hyperlipidemia, or diabetes in those with previous diagnosis. We calculated the absolute prevalence difference (APD) between women and men for each metric stratified by immigration status and then determined the difference‐in‐differences for immigrants compared with long‐term residents. Our sample included 5.3 million adults (19% immigrants), with receipt of each metric ranging from 55% to 90%. Among immigrants, women were more likely than men to be screened for hyperlipidemia (APD, 10.8%; 95% CI, 10.5–11.2) and diabetes (APD, 11.5%; 95% CI, 11.1–11.8) and to be treated with medications for hypertension (APD, 3.5%; 95% CI, 2.4–4.5), diabetes (APD, 2.1%; 95% CI, 0.7–3.6) and hyperlipidemia (APD, 1.8%; 95% CI, 0.5–3.1). Among long‐term residents, findings were similar except poorer medication use for diabetes (APD, −2.8%; 95% CI, −3.4 to −2.2) and hyperlipidemia (APD, −3.5%; 95% CI, −4.0 to −3.0]) in women compared with men. Conclusions The overall quality of primary preventive care can be improved for all adults, and future research should evaluate the impact of observed equal or better care in women than men, irrespective of immigration status, on cardiovascular disease incidence.Manav V. VyasAmy Y. X. YuAnna ChuBing YuHibo RijalJiming FangPeter C. AustinMoira K. KapralWileyarticlecardiovascularimmigrationpreventionqualitysexDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 22 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiovascular immigration prevention quality sex Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	cardiovascular immigration prevention quality sex Diseases of the circulatory (Cardiovascular) system RC666-701 Manav V. Vyas Amy Y. X. Yu Anna Chu Bing Yu Hibo Rijal Jiming Fang Peter C. Austin Moira K. Kapral Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults
description	Background We evaluated whether immigration status modified the association between sex and the quality of primary cardiovascular disease prevention in Ontario, Canada. Methods and Results We used a population‐based administrative database‐derived cohort of community‐dwelling adults (aged ≥40 years) without prior cardiovascular disease residing in Ontario on January 1, 2011. In the preceding 3 years, we evaluated screening for hyperlipidemia and diabetes in those not previously diagnosed; diabetes control (HbA1c <7%); and medication use to control hypertension, hyperlipidemia, or diabetes in those with previous diagnosis. We calculated the absolute prevalence difference (APD) between women and men for each metric stratified by immigration status and then determined the difference‐in‐differences for immigrants compared with long‐term residents. Our sample included 5.3 million adults (19% immigrants), with receipt of each metric ranging from 55% to 90%. Among immigrants, women were more likely than men to be screened for hyperlipidemia (APD, 10.8%; 95% CI, 10.5–11.2) and diabetes (APD, 11.5%; 95% CI, 11.1–11.8) and to be treated with medications for hypertension (APD, 3.5%; 95% CI, 2.4–4.5), diabetes (APD, 2.1%; 95% CI, 0.7–3.6) and hyperlipidemia (APD, 1.8%; 95% CI, 0.5–3.1). Among long‐term residents, findings were similar except poorer medication use for diabetes (APD, −2.8%; 95% CI, −3.4 to −2.2) and hyperlipidemia (APD, −3.5%; 95% CI, −4.0 to −3.0]) in women compared with men. Conclusions The overall quality of primary preventive care can be improved for all adults, and future research should evaluate the impact of observed equal or better care in women than men, irrespective of immigration status, on cardiovascular disease incidence.
format	article
author	Manav V. Vyas Amy Y. X. Yu Anna Chu Bing Yu Hibo Rijal Jiming Fang Peter C. Austin Moira K. Kapral
author_facet	Manav V. Vyas Amy Y. X. Yu Anna Chu Bing Yu Hibo Rijal Jiming Fang Peter C. Austin Moira K. Kapral
author_sort	Manav V. Vyas
title	Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults
title_short	Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults
title_full	Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults
title_fullStr	Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults
title_full_unstemmed	Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults
title_sort	immigration status and sex differences in primary cardiovascular disease prevention: a retrospective study of 5 million adults
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/7345691d3e064b17931f4dce3e3ed8b6
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Immigration Status and Sex Differences in Primary Cardiovascular Disease Prevention: A Retrospective Study of 5 Million Adults

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