Sex differences in single and combined cardiovascular medication use

Introduction: Drug therapy is a key component in the prevention and management of cardiovascular disease (CVD). In this study, we assess sex differences in the use of single and combined cardiovascular medication. Methods: We analyzed data from individuals ≥40 years old between 2010 and 2020 in the PHARMO Data Network, which included data from out-patient pharmacies and primary care across the Netherlands. Included individuals were either at high-risk for CVD or were previously diagnosed with CVD. Dispensed cardiovascular medications were categorized into ten medication classes, based on their active substances. Concomitant medication was defined as medication dispensed in the same semester. Sex-specific dispense patterns and women-to-men prevalence ratios (PRs) were calculated for groups stratified by age and CVD status. Results: In total, 53,110 individuals at high-risk for CVD (36% women) and 71,996 individuals diagnosed with CVD (45% women) were included. Fifty out of 645 drug combinations had a median prevalence of ≥1%. Combinations of five or more drugs were more frequent in men compared to women, regardless of age and CVD status (range prevalence difference between sexes: 2-5%). Specifically, three combinations of five or more drugs were more often dispensed to men than women (PR range: 0.5-0.7). Conclusion: This study highlights sex differences in the number and types of dispensed combined cardiovascular medication, with dispenses of five or more cardiovascular drugs being more common in men than women. Age, sex, and CVD status contributed to differences in specific dispensed combinations.