Key result
Among patients with diabetes in primary care, women were less likely to achieve LDL-c control (RR 0.88) and more likely to achieve systolic blood pressure control (RR 1.06) than men.
Why the study?
Diabetes is a stronger risk factor for cardiovascular complications in women than men, prompting evaluation of potential sex differences in cardiovascular risk management in primary care.
Are there sex differences in cardiovascular risk management in patients with diabetes in primary care?
Cross-Sectional (n=12,512)
Yes
Are there sex differences in cardiovascular risk management in patients with diabetes in primary care?
In a Dutch primary care setting, sex differences in cardiovascular risk management for patients with diabetes were small, though women were less likely to achieve LDL-c control and more likely to achieve blood pressure control than men.
Answers are grounded in this paper and cite their sources.
Small sex differences in risk factor control among diabetes patients should not yet change practice; leaves open need for longitudinal outcome studies.
Background Diabetes is a stronger risk factor for cardiovascular complications in women than men. Aim To evaluate whether there are sex differences in cardiovascular risk management in patients with diabetes in primary care. Design & setting A cross-sectional study was undertaken using data from 12 512 individuals with diabetes within the Dutch Julius General Practitioners Network (JGPN) from 2013. Method Linear and Poisson regression analyses were used to assess sex differences in risk factor levels, assessment, treatment, and control. Results No sex differences were found in HbA1c levels and control, while small differences were found for cardiovascular risk management. Blood pressure levels were higher (mean difference [MD] 1.09 mmHg; 95% confidence intervals [CI] = 0.41 to 1.77), while cholesterol levels (MD -0.38 mmol/l; 95% CI = -0.42 to -0.34) and body mass index ([BMI] MD -1.79 kg/m 2 ; 95% CI = -2.03 to 1.56) were lower in men than women. Risk factor assessment was similar between sexes, apart from high-density lipoprotein cholesterol (HDL-c), which was more commonly assessed in women (risk ratio [RR] 1.16; 95% CI = 1.13 to 1.20). Among those with a treatment indication for prevention, women with cardiovascular disease (CVD) were less likely to receive lipid-lowering drugs (RR 0.84; 95% CI = 0.76 to 0.93) than men, while women without CVD were more likely to receive lipid-lowering drugs (RR 1.16; 95% CI = 1.04 to 1.2). Among those treated, women were more likely to achieve systolic blood pressure (SBP) control (RR 1.06; 95% CI = 1.02 to 1.10) and less likely to achieve low-density lipoprotein cholesterol (LDL-c) control (RR 0.88; 95% CI = 0.85 to 0.91) than men. Conclusion In this Dutch primary care setting, sex differences in risk factor assessment and treatment of people with diabetes were small. However, women with diabetes were less likely to achieve control for LDL-c and more likely to achieve blood pressure control than men with diabetes.
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Jong et al. (2019) conducted a cross-sectional in Diabetes mellitus (n=12,512). Female sex vs. Male sex was evaluated on Achievement of low-density lipoprotein cholesterol (LDL-c) control among treated individuals (RR 0.88, 95% CI 0.85 to 0.91). Among patients with diabetes in primary care, women were less likely to achieve LDL-c control (RR 0.88) and more likely to achieve systolic blood pressure control (RR 1.06) than men.
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