Recent Studies Point to Differences between Men and Women in Cardiovascular disease and Diabetes

Women have over 40 per cent more excess risk of serious heart conditions after contracting diabetes than men, a major review has found. Published in Diabetologia, the study covered about 860,000 patients.

Senior Author Professor Mark Woodward, from The George Institute for Global Health and The Universities of Oxford and Sydney, said the study closely followed another, of similar size, that found that women had a 27 per cent greater excess risk of stroke conferred by diabetes than men (published in the Lancet).

“The two studies taken in conjunction show diabetes poses a greater cardiovascular hazard to women than to men.”

He said the reason for the disparity has not been confirmed.

“Our review suggests that the diabetes-related excess risk of stroke in women is due to undetected and therefore untreated higher cardiovascular risk profiles in prediabetic condition,” said Woodward about the Lancet study. “If this is the case, then putting in place earlier detection and treatment for diabetes for women could substantially help prevent cardiovascular events.”

“It has long been speculated that women have been relatively undertreated compared to men, and that women with diabetes are more likely to have a higher cardiovascular risk. However, even when treated similarly, women are still at higher risk. This suggests that there are other factors in play.”

A more recent hypothesis was that women develop diabetes at a later stage than men, Professor Woodward said. Several studies have suggested men developed diabetes at a lower level of BMI compared with women. “For example, data from the UK Prospective Diabetes Study indicated that men with newly diagnosed diabetes were significantly less obese compared with newly-diagnosed women.”

Findings such as these, when combined with the fact that the cardiovascular burden in women is actually greater than for men, and that these differences may increase in the future due to aging populations, longer female life expectancy and delays in the development of symptomatic CVD in women relative to men highlight these areas are important for further study.

It may be necessary to develop a programme of gender-specific intervention, targeting women with increased pre-diabetic screening, combined with more stringent follow-up of women at high risk for diabetes such as women with a history of gestational diabetes, Professor Woodward said.

The World Health Organization estimates that the cardiovascular risk in people with diabetes is two to three times higher than in those without the disease, and that 50-80% of deaths in people with diabetes are caused by cardiovascular diseases.

Click here to view a summary of the article on The Lancet website.