Alison M Whitehead1, Nancy H Maher1, Karen Goldstein2, Bevanne Bean-Mayberry3, Claire Duvernoy4, Melinda Davis5, Basmah Safdar6, Fay Saechao7, Jimmy Lee8, Susan M Frayne8,9, Sally G Haskell1,10. 1. Department of Veterans Affairs, Central Office, Washington, District of Columbia. 2. Durham VA and Duke University School of Medicine, Durham, North Carolina. 3. VA Greater Los Angeles and Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California. 4. VA Ann Arbor Healthcare System, University of Michigan, Ann Arbor, Michigan. 5. Department of Medicine, Cardiology Clinic, University of Michigan, Ann Arbor, Michigan. 6. Department of Emergency Medicine, Yale University, New Haven, Connecticut. 7. VA Health Services Research and Development (HSR&D) Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California. 8. VA HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California. 9. Division of Primary Care and Population Health, Stanford University, Stanford, California. 10. VA Connecticut Healthcare System and Yale University, West Haven, Connecticut.
Abstract
Background: In the U.S. civilian population, sex differences have been identified in cardiovascular health; these differences have been used to inform care. Our objective is to determine if the same sex differences are present in Veterans who use the Department of Veterans Affairs (VA) Health Care System given the additional stressors associated with military service. Materials and Methods: Cardiovascular disease (CVD) risk factors and conditions among women and men Veterans using VA in fiscal year (FY) 2014 were identified through the presence of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes in VA administrative records. ICD-9-CM codes were grouped into conditions; prevalence was examined by gender overall, by age, and by race/ethnicity. Results: Within the FY 2014 cohort of VA Veteran patients included in this analysis, 7.1% (n = 412,901) were women and 92.9% were men (n = 5,376,749). Compared with men, women in this cohort were younger and more ethnically diverse. Overall, women were less likely to have traditional CVD risk factors, but more likely to have a nontraditional CVD risk factor (depression) compared with men. Women had higher odds of chest pain/angina (adjusted odds ratio [AOR] 1.03, confidence interval [95% CI] 1.02-1.05), palpitations (AOR 2.04; 95% CI 1.98-2.10), and valvular disease (AOR 1.05; 95% CI 1.02-1.08), but lower odds of coronary artery disease (AOR 0.29; 95% CI 0.29-0.30), acute MI (AOR 0.46; 95% CI 0.43-0.49), and heart failure (AOR 0.55; 95% CI 0.53-0.56) compared with men, overall. Conclusions: In age-adjusted comparisons, sex differences in the prevalence of CVD risk factors and conditions among the VA Veteran patient population was similar in that seen in the civilian population with a few exceptions.
Background: In the U.S. civilian population, sex differences have been identified in cardiovascular health; these differences have been used to inform care. Our objective is to determine if the same sex differences are present in Veterans who use the Department of Veterans Affairs (VA) Health Care System given the additional stressors associated with military service. Materials and Methods:Cardiovascular disease (CVD) risk factors and conditions among women and men Veterans using VA in fiscal year (FY) 2014 were identified through the presence of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes in VA administrative records. ICD-9-CM codes were grouped into conditions; prevalence was examined by gender overall, by age, and by race/ethnicity. Results: Within the FY 2014 cohort of VA Veteran patients included in this analysis, 7.1% (n = 412,901) were women and 92.9% were men (n = 5,376,749). Compared with men, women in this cohort were younger and more ethnically diverse. Overall, women were less likely to have traditional CVD risk factors, but more likely to have a nontraditional CVD risk factor (depression) compared with men. Women had higher odds of chest pain/angina (adjusted odds ratio [AOR] 1.03, confidence interval [95% CI] 1.02-1.05), palpitations (AOR 2.04; 95% CI 1.98-2.10), and valvular disease (AOR 1.05; 95% CI 1.02-1.08), but lower odds of coronary artery disease (AOR 0.29; 95% CI 0.29-0.30), acute MI (AOR 0.46; 95% CI 0.43-0.49), and heart failure (AOR 0.55; 95% CI 0.53-0.56) compared with men, overall. Conclusions: In age-adjusted comparisons, sex differences in the prevalence of CVD risk factors and conditions among the VA Veteran patient population was similar in that seen in the civilian population with a few exceptions.
Entities:
Keywords:
Veterans; cardiovascular health; disparities; women
Authors: Sanket S Dhruva; James Dziura; Harini Bathulapalli; Lindsey Rosman; Allison E Gaffey; Melinda B Davis; Cynthia A Brandt; Sally G Haskell Journal: J Gen Intern Med Date: 2022-08-30 Impact factor: 6.473
Authors: Allison E Gaffey; Matthew M Burg; Lindsey Rosman; Galina A Portnoy; Cynthia A Brandt; Casey E Cavanagh; Melissa Skanderson; James Dziura; Kristin M Mattocks; Lori A Bastian; Sally G Haskell Journal: J Womens Health (Larchmt) Date: 2021-01-13 Impact factor: 3.017