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Back to Cardiology Articles
Monday 21st February, 2005
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Women with diabetes have a significantly greater risk of dying from
coronary heart disease (CHD) than men with diabetes.
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ORLANDO, Feb. 18 ? Women with diabetes have a significantly
greater risk of dying from coronary heart disease (CHD) than men
with diabetes, researchers reported today at the Second
International Conference on Women, Heart Disease and Stroke.
Diabetes is a well-established CHD risk factor known to
double a person's chance of dying from heart disease. There has
been much debate, but no large studies of whether diabetes
carries different heart risks for women than for men, said Mark
Woodward, Ph.D., professor of biostatistics at The George
Institute for International Health at the University of Sydney,
Australia.
Using data on more than 450,000 people, which included
participants in the Asia Pacific Cohort Studies Collaboration,
researchers found that men with diabetes had about 90 percent
higher risk of dying from CHD as men without diabetes. Women
with diabetes had more than two and a half times the risk of
women without diabetes. That translates to a greater than 50
percent excess relative risk for women than for men, he said.
The data came from two previous meta-analyses of 16 studies
and a collaborative overview of 44 studies in nine countries in
the Asia-Pacific Region (China, Japan, South Korea, Taiwan, Hong
Kong, Singapore, Thailand, New Zealand and Australia).
About 5 percent of all the participants had diabetes.
Diabetes was defined according to self-reported history with or
without fasting glucose evidence as an alternative. The
researchers were able to adjust for age, systolic blood
pressure, total cholesterol and cigarette smoking in most of the
data sets, he said.
Perhaps better monitoring and control of blood glucose levels
in women with diabetes would reduce their CHD risk compared with
men with diabetes, Woodward said.
"There is some evidence to suggest that people with diabetes
benefit from treatment with aspirin, cholesterol-lowering drugs
and blood pressure-lowering agents," he said.
This meta-analysis has similar drawbacks to most overviews
including the possibility of publication bias (in this case the
exclusion of studies that did not report sex-specific results),
misdiagnosis of diabetes, lack of information on an individuals'
medical treatment, no information on menopause status or on
whether subjects had Type 1 diabetes, due to the body's
inability to produce insulin, or Type 2 diabetes, initially
caused by the inability to use the insulin produced. Data from
randomized trials of individuals with diabetes would clarify
these issues.
Besides continuing to seek data on the sex-specific relative
risk for CHD related to diabetes, researchers at the George
Institute are leading a large scale randomized trial Action in
Diabetes and Vascular Disease: Preterax and Diamicron MR
Controlled Evaluation (ADVANCE) on 11,140 people. They are
trying to ascertain whether more intensive glucose control
combined with blood pressure lowering reduces cardiovascular
mortality in people with Type 2 diabetes. The trial, which will
follow participants for 4 ? years on average, will end in 2006.
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