Physician–patient sex dyads and management of dyslipidaemia and hypertension in primary care: findings from two population-based studies

OBJECTIVE: To examine associations between physician-patient sex dyads and the prevalence, treatment, and control of dyslipidaemia and hypertension in primary care. METHODS: We analysed two Swiss population-based studies using mixed-effects logistic models to compare dyslipidaemia and hypertension management across four physician-patient sex dyads (male physician-male patient, male physician-female patient, female physician-male patient, female physician-female patient). Age-stratified analyses (≥50, ≥60 years) examined whether dyad-outcome associations differed by patient age. RESULTS: Among 8,635 participants (54.9% females; mean age 63 years in CoLaus study and 48 years in Bus Santé study), females had lower prevalences of dyslipidaemia and hypertension than males across both study samples, irrespective of physician sex. For dyslipidaemia, in CoLaus, females had higher odds of lipid-lowering therapy yet lower odds of LDL-C control, regardless of physician sex; in Bus Santé, females managed by male physicians had lower odds of lipid control (adjusted OR 0.52, 95% CI 0.28-0.95) compared to male physician-male patient dyads. For hypertension, in CoLaus, female physician-female patient dyads had lower odds of antihypertensive treatment (adjusted OR 0.62, 95% CI 0.42-0.92) than male physician-male patient dyads; in Bus Santé, treatment and control did not differ significantly by dyad. Most differences were more pronounced in patients aged 60 years or older. CONCLUSION: In primary care, patterns of risk-factor management were associated with both patient and physician sex, with dyad-related differences that may reflect patient-sex patterns but differ in magnitude across regions and age groups.