Women at Risk: Diabetes and Heart Disease

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Sex disparities in the treatment and control of cardiovascular risk factors in type 2 diabetes, by Ioanna Gouni-Berthold and colleagues. Diabetes Care 31: 1389-1391, 2008

What is the problem and what is known about it so far?

Deaths from heart and blood vessel disease have been declining in recent years in both men and women. But among people with type 2 diabetes, this improvement has only been observed among men. In fact, women have a 50% greater chance of dying from diabetes-related heart disease than do men. This may be because women have more risk factors for developing heart and blood vessel disease, or because such risk factors are treated better in men, or both. A study of managed-care health plans in the United States found poorer control of blood pressure and LDL cholesterol (the "lousy" cholesterol) in women, but there have been no similar studies in Europe.

Why did researchers do this particular study?

The researchers wanted to find out whether heart and blood vessel disease risk factors are better controlled and treated more intensively for men than for women in Germany.

Who was studied?

This study reviewed data from a registry of nearly 45,000 type 2 diabetic patients, half of whom were women and nearly 40% of whom had existing heart and blood vessel disease.

How was the study done?

The researchers looked at data about the intensity of treatments prescribed for uncontrolled heart and blood vessel disease risk factors, including high LDL cholesterol, high blood pressure, and high A1C levels.

What did the researchers find?

Women with heart and blood vessel disease were less likely to have their blood pressure, LDL cholesterol, and A1C controlled and less likely to receive intensive treatment to control their cholesterol levels. Women without existing heart and blood vessel disease were less likely than men to have their LDL cholesterol controlled, although their control of blood pressure and A1C levels did not differ from that of men.

What were the limitations of the study?

The design of the study did not allow researchers to draw conclusions about the specific nature of links between various risk factors and the rate of heart and blood vessel disease in participants.

What are the implications of the study?

Although physicians often tend to focus on controlling blood glucose in patients with diabetes, attention to controlling blood pressure and especially cholesterol levels may be more beneficial in terms of helping patients avoid heart and blood vessel disease. More intensive combination treatment of high blood pressure, high LDL cholesterol, and high blood glucose in women may reduce the higher risk of heart and blood vessel disease for women.

FOR MORE INFORMATION

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