Diabetes triples women's risk of death from ischemic heart disease

Diabetes triples the risk of death from ischemic heart disease or stroke in women and doubles the risk in men with no previous vascular disease, according to new research published in The Lancet Diabetes & Endocrinology. 

“Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain,” wrote lead author Sarah Lewington, DPhil, University of Oxford, and colleagues. “We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men.”

The researchers reviewed health data from more than 980,000 adults from 68 observational studies, which were conducted in 19 countries. Baseline data included age, gender, height, weight, diabetes status, cholesterol, blood pressure and tobacco use.

Overall, 4.3 percent of participants reported having diabetes at recruitment—5 percent of men and 3.4 percent of women. The prevalence of diabetes increased from 2.1 percent in men and 1.4 percent in women at age 40 to 8.9 percent in men and 6 percent in women at age 70.

Of the 58,700 individuals in the study cohort who reported no history of diabetes but who had a measurement of glucose, only 2 percent had a glucose measurement indicating undiagnosed diabetes.

Diabetes at ages 35-89 years more than doubled vascular mortality risk; however, the risk for death was higher in women versus men. Women aged 35 to 59 had the highest risk for mortality across all age and gender groups.

“Even after controlling for total cholesterol, blood pressure, BMI, and smoking status, diabetes conferred a doubling in occlusive vascular mortality risk among men aged 35-89 years, but a tripling in risk among similarly aged women,” Lewington and colleagues wrote. “Among women especially, diabetes death rate ratios were higher at younger ages than at older ages, so that at ages 35-59 years, diabetes was associated with a five to six times increased risk of occlusive vascular mortality.”

The researchers noted public health strategies should target lifestyle changes for these individuals. They added wider use of cost-effective drug treatment to reduce vascular risks are important among both men and women with diabetes.

“Future research should consider which emerging risk factors account for the relative excess risk of occlusive vascular disease among women with diabetes,” Lewington et al. concluded.

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As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.

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