Gender Does Make A Difference
Treating male patients with dyslipidaemia could be more challenging

Across the globe, women have shown consistently more favourable lipid profiles as compared to men. Locally, as well, the National Health Surveys have revealed the same since the 1990s.

While our lifestyle habits have been linked to this gender difference in several overseas population-based studies, a more recent study conducted by the Department of Research of SingHealth Polyclinics has brought to light some of these lifestyle behaviours in the local context. The study was published in the journal, Proceedings of Singapore Healthcare.

For instance, fewer Singaporean men were found to have attained their LDL-Cholesterol (LDL-C) Treatment Goals as compared to women. This appeared to have been associated with a greater reluctance to embark on dietary changes, unlike women, who tended to be more weight and health-conscious.

It was also found that men dined out more regularly, which could make it harder for them to make the necessary changes. In the study, a higher proportion of women were homemakers, which could place them in a better position with regard to their food choices.

Selecting more healthy options when dining out is the way to go, says Dr Tan Ngiap Chuan, the principal investigator of the study.

“But we do not suggest an abstinence from the less healthy food options. They can, instead, moderate their intake in terms of the quantity and its frequency.”

Among the men, those of Chinese ethnicity and with lower educational levels were found to have better LDL-C control, as were non-smokers and non-drinkers. Both the activities of smoking and alcohol intake are known factors that lead to a rise in LDL-C.

“Therefore, primary care physicians should actively advise their patients to stop smoking, and to moderate their alcohol intake to no more than one unit per week, regardless of the type of alcohol consumed,” said Dr Tan.

Interestingly, among women, those who perceived the lipid-lowering therapy to be expensive were less likely to achieve their LDL-C Treatment Goal. Physicians can help to overcome this barrier, by proactively raising the issue during their consultations, and by helping the affected patients obtain financial assistance.

“It is important that physicians recognise that it will be more challenging to manage their male patients with dyslipidaemia. A multi-faceted team-based approach may be one option, focusing on medication adherence and lifestyle changes,” advised Dr Tan.