Two studies being presented at the European Association for the Study of Diabetes Annual Meeting suggest that, compared to men with the condition, women with diabetes have an increased risk of severe heart complications, including a 34% higher risk of heart attack and a 40% higher risk of acute coronary heart syndrome (ACS).
In the first study, Dr Giuseppe Seghieri and colleagues, from the Regional Health Agency, Florence, Italy, retrospectively pooled data from a registry of 3 192 203 inhabitants of the Tuscany region of Italy between 2005 and 2012. After adjustment for age, compared with people without diabetes, the hazard ratio (HR) for acute myocardial infarction (MI) was 2.63 in women with diabetes and 1.96 in men with the condition. This equated to an excess of 34% in women. After stratifying the population according to age, the greatest difference between the genders was observed at the age of 45–54 years (HR, 5.83 in women vs. 2.88 in men). Overall, no gender difference was observed in terms of risk of ischaemic stroke or congestive heart failure (CHF), although a higher excess risk in women started to appear over the age of 55 years.
The authors concluded that “the excess risk of cardiovascular events linked with diabetes is significantly different between genders. With respect to acute MI, diabetic women are more disadvantaged, compared to diabetic men, with a gender-driven ‘risk window’ for women which mostly opens around menopausal age (45 years onwards). Regarding ischaemic stroke and CHF, it opens later, in the postmenopausal age (55 years and over), and to a lesser extent. All this should focus attention on a timely, gender oriented, prevention of cardiovascular events in people with diabetes.”
In the second study, Dr Xue Dong (Affiliated ZhongDa Hospital of Southeast University, Nanjing, China) and colleagues performed a meta-analysis of 9 case–control and 10 cohort studies conducted in countries including Canada, the US, China and Germany. Pooled data from 10 856 279 individuals showed that the adjusted relative risk of ACS associated with diabetes was 2.45 in women and 1.68 in men, equating to an excess risk of 38% in women. Commenting on the findings, the authors stated: “We should avoid sexual prejudice in cardiovascular disease, take all necessary steps to diagnose it early, and control risk factors comprehensively to guarantee the most suitable treatments and best possible outcomes in female patients.”
These findings were presented at the 51st Annual Meeting of the European Association for the Study of Diabetes, Stockholm, Sweden, 14–18 September, poster numbers 265 and 269, respectively. Full manuscripts are being prepared for submission to journals.
