Differenze di genere e ipercolesterolemia: evidenze real-world dallo studio WECARE (Women Effective CArdiovascular Risk Evaluation)

Gender differences and hypercholesterolemia: real-world evidence from the study WECARE (Women Effective
CArdiovascular Risk Evaluation)
Introduction: The therapeutic control of LDL-cholesterol is essential in cardiovascular prevention, as recommended
by the recent guidelines.
Objective: To evaluate gender differences in terms of demographic and clinical characteristics, treatment pattern,
treatment adherence and healthcare costs in patients on lipid-lowering therapy, stratified by cardiovascular risk
in the Italian real clinical practice.
Methods: An observational analysis was conducted on the administrative databases of healthcare institutions,
covering about 6.1 million health-assisted subjects. After inclusion of all patients on lipid-lowering therapy between
January 2017 and June 2020, the population was investigated in the period before the first prescription of
a lipid-lowering drug and followed-up for at least 12 months. Clinical and demographic variables were compared
after stratification by gender and by cardiovascular risk (very high/high/other risk). The main outcome measures
were treatment adherence and direct healthcare costs during follow-up.
Results: Of the 684,829 patients with high/very high cardiovascular risk, 337,394 were men and 347,435 women,
aged on average 69.3 years and 72.1 years, respectively (p < 0.001). Men were characterised by a worse comorbidity
profile. Regardless of cardiovascular risk, female subjects were associated with larger utilisation of lowpotency
statins and lower adherence (p < 0.001). The annual healthcare costs per patient during follow-up were
higher in men than in women (p < 0.001).
Conclusions: The results highlighted larger utilisation of low-potency statins, a lower adherence and a milder
comorbidity profile in women, the latter feasibly explaining the reduced healthcare costs compared to men.
Keywords: Cardiovascular risk, Healthcare costs, LDL-cholesterol, Lipid-lowering therapy, Therapeutic adherence