Among people with diabetes, women are significantly less likely than men to receive comprehensive care to prevent cardiovascular disease — even though women face about the same level of risk as men, according to a new study presented at the 2021 meeting of the European Association for the Study of Diabetes and described in an article at Nursing Times.
Diabetes — type 1 or type 2 — is a well known risk factor for cardiovascular disease, although people with different diabetes types face somewhat different risks. In fact, cardiovascular disease is the leading cause of death in people with type 2 diabetes. A number of different factors have been linked to cardiovascular disease risk, including lifestyle measures that people may be able to control. Just this year, studies have found a higher cardiovascular disease risk linked to behaviors like eating highly processed foods, working long hours, and using alcohol, tobacco, and other drugs. But some of the most important steps people can take to help prevent cardiovascular disease involve screening and risk factor management — such as by keeping blood pressure, blood lipids (cholesterol and triglycerides), and body weight under control.
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For the latest study, researchers looked at data from 9,901 participants in a clinical trial called REWIND, which included adults with type 2 diabetes from 24 countries. All participants had either a high risk for cardiovascular disease or established cardiovascular disease at the time of enrollment, but fewer women (20.0%) than men (41.4%) had established disease. The researchers were interested in whether there were differences between men and women in how cardiovascular risk factors were managed, as well as in outcomes related to cardiovascular disease.
Fewer women meeting key cardiovascular benchmarks
The researchers found that the majority of women in the study met recommended targets for blood pressure (97%) and blood lipids (73%). But fewer women than men met some other key benchmarks — for use of recommended medications like ACE inhibitors or angiotensin receptor blockers (80%, compared with 83% of men) and statins (73%, compared with 81% of men). Over a follow-up period averaging about two years, women were less likely than men to meet targets for LDL (low-density lipoprotein, or “bad”) cholesterol, regardless of whether they already had a cardiovascular event like a heart attack or a stroke. Still, women were less likely than men to experience poor cardiovascular outcomes, with the notable exception of stroke — possibly due to differences in how cardiovascular disease affects men and women regardless of prevention strategies. Compared with men, women with a history of cardiovascular disease at the beginning of the study had a similar risk for stroke, hospitalization for heart failure, death from cardiovascular causes, and death from all causes.
“Women, overall, were less likely than men to reach treatment targets for [cardiovascular] risk management. Nonetheless, they remained at lower risk for all adverse [cardiovascular] outcomes except stroke,” the researchers concluded. “These findings warrant further investigation in women with [type 2 diabetes].”
Want to learn more about protecting your heart? Read “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Lower Your Risk of Heart Disease.”