Sex-Based Differences in Cardiovascular Outcomes and Management Approaches in Late-Onset Hypertension
Bibliographic record
Abstract
There may be sex-based differences in the care and treatment of people with late-onset hypertension. This thesis aims to investigate the evaluation, initial pharmacological management, and important clinical outcomes, of older adults with a new diagnosis of hypertension. We conducted a population-level cohort study of all Ontario residents 66 years and older with a new diagnosis of hypertension between January 1, 2010 and December 2017. Sex was the exposure. We defined outcomes in the period of 2011 to 2021, with at least 1 year of follow-up. The first manuscript examined a primary outcome that was a composite of adverse cardiovascular events in 266,273 individuals with a new diagnosis of hypertension, defined as: any nonfatal ischemic stroke, nonfatal myocardial infarction, or congestive heart failure, by calculating hazard ratios (HR) using a Cox proportional hazards model. The second manuscript examined 111,410 individuals with a new diagnosis of hypertension but not previously on any medications that could lower blood pressure (BP), in terms of application of Hypertension Canada guideline-recommended investigations for a new diagnosis of hypertension, using Poisson regression. We also examined the initial prescription of a guideline-recommended medication for lowering blood pressure using Cox proportional hazards regression. This thesis shows that females were less likely to have the primary composite outcome despite finding no differences in performance of guideline-recommended investigations for a new diagnosis of hypertension and in prescribing of guideline-recommended medication for hypertension. Unmeasured confounding may account for some of these findings. Our findings suggest that sex-based differences in the outcomes of late-onset hypertension exist, and further studies are required to address these gaps.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".