Young and middle-aged women with type 2 diabetes are at much greater risk of coronary artery disease than previously believed, according to a study.
Among women younger than 60 who have diabetes, their risk of coronary artery disease increases by up to four times, making it roughly equal to mens risk of this same form of heart disease, Johns Hopkins researchers reported Oct. 31 on the website of the journal Diabetes Care.
Our findings suggest that we need to work harder to prevent heart disease in women under 60 who have diabetes, Rita Rastogi Kalyani, MD, MHS, the studys lead author and an endocrinologist at the Johns Hopkins University School of Medicine in Baltimore, said in a news release. This study tells us that women of any age who have diabetes are at a high risk for coronary artery disease.
While men generally have a higher incidence of heart disease than women, the study found that diabetes had little or no effect on mens heart disease risk. Kalyani said the new study is believed to be the first to focus specifically on gender differences in coronary artery disease among younger and middle-aged people with diabetes.
Kalyani and colleagues analyzed data from more than 10,000 participants in three highly regarded studies: the GeneSTAR Research Program, the Multi-Ethnic Study of Atherosclerosis and the National Health and Nutrition Examination Survey III. None of the participants had a history of heart disease. All three studies yielded similar gender differences in rates of diabetes and the risk of developing heart disease.
Our study adds to growing evidence that gender differences exist in the risk of coronary artery disease brought on by diabetes, Kalyani said.
In both women and men, these findings were unrelated to differences in obesity and other traditional cardiovascular risk factors such as hypertension, cholesterol and smoking.
The researchers offer several possible explanations for the increased risk. There could be distinct genetic and hormonal factors related to the development of heart disease by gender. Differences in adherence to heart-healthy lifestyle behaviors, compliance and treatment of cardiovascular treatments between genders also are possible but need to be further investigated, Kalyani said. Also, the relationship of diabetes duration and glucose control to risk of heart disease remains unclear.
Study abstract: http://care.diabetesjournals.org/content/early/2013/10/22/dc13-1755.abstract