Diabetic Women More Likely to Have Cardiovascular Death and Insufficient Treatment

In the past few years, there has been an observed decrease in deaths resulting from cardiovascular disease (CVD) in both men in women. For those with type 2 diabetes though, which is a major risk factor for CVD events (heart attacks and strokes), this mortality decrease has only been seen in men. A recent study has set out to discover why this decrease did not occur in diabetic women, who have always had more CVD fatalities then diabetic men, as well.

Past research has established that women with diabetes are 50% more likely to suffer death from a CVD event than men. Explanations for this fact have ranged from diabetic women naturally having more CVD risk factors than men, to diabetic treatments being more favorable for men than women. For the general population of women in the U.S, studies have indicated that there is “poorer control of blood pressure and LDL cholesterol in female compared with male patients and suggested that these findings may contribute to the sex disparity in CVD mortality trends.” These risk factors were under primary investigation for diabetic men and women in the current study.

44,893 individuals participated in the study, 51% being women. High blood pressure (defined as 140 mmHg or more) and high bad (LDL) cholesterol (130 mg/dl), were considered as risk factors for CVD events and analyzed in both men and women in the study. Also, the general intensity of treatment for these risk factors in diabetics was investigated in order to see if men and women were treated differently.

Results showed that 63% of patients had high blood pressure and 48% had high LDL. The study further showed that for those with a history of CVD, women were much more likely to have high blood pressure and high cholesterol. For those with no history of CVD, women were only more likely to have high cholesterol than men.

In the analysis of treatment intensities (which includes lipid lowering medication administration for high cholesterol and antihypertensive and antihyperglycemic medications for high blood pressure), it was shown that “among those with a history of CVD, the medication intensity was similar in men and women with respect to antihypertensive and antihyperglycemic medications, but women received significantly less lipid-lowering medications. Among patients without a history of CVD, there were no significant differences.”

The results of this study indicate that diabetic women were always more likely than men to have have high cholesterol, and for patients with CVD history, women were more likely to have high blood pressure as well. In addition, though more women have high cholesterol than men, fewer are treated with lipid-lowering medications. The study authors conclude that “these results are of particular interest, since it has been shown that the stronger effect of type 2 diabetes on the risk of coronary heart disease in women is in part explained by a greater effect of atherogenic dyslipidemia [high lipid levels] and blood pressure in diabetic women.” Diabetic women should be aware of their increased risk for CVD, and doctors should administer the proper preventative medications accordingly.

Source: Defeat Diabetes Foundation: Gouni-Berthold, Ioanna. Krone, Wilhelm. et al. Diabetes Care. “Sex Disparities in the Treatment and Control of Cardiovascular Risk Factors in Type 2 Diabetes.” July 2008.