Abstracts / Posters
Gender Differences in coronary risk factors: Community screening in obesity
Oral presentation by Felicity Lyons at International Congress on Obesity, Brazil 2002
The Counterweight Project Team
Introduction: Obesity, a main disease-cause, is under recognised in primary care, so we examined weight-screening rates & obesity-related co-morbidities.
Methods: The Counterweight Programme (UK, 7 centre obesity pilot) first phase audited 4000 patients (18-75y; BMI³30), a random 100 from 40 practices. All medical records for 18 months were reviewed, and compared with whole practice data in 34 practices (n=182,474) for weight, BMI & obesity prevalence.
Results: Weight & BMI were more often recorded in females (both p<0.0001), but obesity prevalence was only 45% of that expected (England Health Survey), implying measurement avoidance in those overtly obese. Obese males (n=1640) were more likely than females (n=2360) to have ³1 lipid profile (42.1:28.6%, p<0.0001) & a recorded hyperlipidemia prevalence of 12.1:7.6% (p<0.0001). Diabetes screening rates (³1 glucose) were similar (25.7:27.3%), but male prevalence of diagnosed diabetes was higher (16.3:10.7%, p<0.0001). Diabetic males were more likely to have had HbA1c data in the previous 18 months (63.8:53.5%, p<0.05), despite higher consultation rates for women (p<0.01). Hypertension screening rates and prevalence by gender were similar.
Conclusion: With women more likely to be weighed than men, <50% of overweight and obese patients were identified in primary care records. Adjusting for recording differences, diabetes is more common but hyperlipidemia similar in obese males compared to females. Men who are identified as obese in primary care records then appear to have improved medical care compared to women, with more (albeit insufficient) lipid and diabetes monitoring, despite higher female consultation rates. Why are different agendas followed in female compared to male consultations?