Women with diabetes more at risk from CHD than men

February 18, 2005

February 18, 2005

Orlando, FL - Women with diabetes have a significantly greater risk of dying from coronary heart disease (CHD) than men with diabetes, according to a new meta-analysis in over 450 000 people reported at the Second International Conference on Women, Heart Disease, and Stroke.[ 1 ]

Biostatistician Dr Mark Woodward (University of Sydney, Australia) presented the findings, which come from two previous meta-analyses of 16 studies and a collaborative overview of 44 trials in nine countries in the Asia-Pacific region.

"The message here is that women with diabetes should have things like blood pressure treated at least as aggressively, and perhaps more aggressively, than men," Woodward told heart wire .


First large study to show a differential

Although there has been much discussion about whether diabetes carries CHD risks for men that are different from those for women, there have been no large studies so far, Woodward said. Previous collaborative trials have generally had insufficient numbers to reliably quantify the sex difference, if any, in CHD risk associated with diabetes, he noted.

Woodward and colleagues carried out a random effects meta-analysis of study-specific relative risks for CHD mortality for both men and women and tested for sex heterogeneity in the pooled results. Adjustment was made for age, systolic blood pressure, total cholesterol, and smoking in most of the data sets.

Overall, women with diabetes had an excess risk of CHD mortality compared with men (relative risk 2.48 vs 1.87; p=0.006). This translates into an excess relative risk of around 50% of dying from heart disease for women compared with men.

Woodward said there are several possible reasons for the findings. "First, it could be that women simply have a more 'virulent' form of diabetes than men. Second, it could be due to differences in lipids—we know already that women with diabetes have higher triglyceride levels and lower high-density lipoprotein levels than men with diabetes."

In my opinion, the most likely explanation is that women don't receive as good treatment as men.

Finally, he says, "In my opinion, the most likely explanation is that women don't receive as good treatment as men: cardiovascular disease is still seen by many to be a male disease. The key thing here is blood-pressure reduction."

Thus, the data suggest that more aggressive treatment of diabetes in women will help offset the increase in CHD that is apparent, Woodward concluded.

Source

  1. Woodward M, Barzi F, Huxley R. Women have a greater excess relative risk for coronary death associated with diabetes than men. Second International Conference on Women, Heart Disease, and Stroke. February 16-19, 2005; Orlando, FL. Abstract P155.

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