Among diabetic patients with CVD, men had significantly lower probabilities of uncontrolled systolic blood pressure (41.2% vs 46.6%) and LDL cholesterol (22.4% vs 28.3%) compared to women.
Cross-Sectional (n=8,821)
Yes
Are there sex differences in the control and treatment of modifiable cardiovascular disease risk factors among patients with diabetes?
Women with diabetes and a history of CVD have poorer control of systolic blood pressure and LDL cholesterol compared to men, which may contribute to observed sex disparities in CVD mortality trends.
Effect estimate: Risk difference -5.4% (95% CI -9.5 to -1.3)
Absolute Event Rate: 41.2% vs 46.6%
Absolute Risk Reduction: -5.4%
OBJECTIVE: Cardiovascular disease (CVD) mortality has decreased in men but not in women with diabetes. We investigated whether sex differences in control and treatment of CVD risk factors might underlie this disparity. RESEARCH DESIGN AND METHODS: We performed cross-sectional analyses from a cohort of patients with diabetes sampled from 10 U.S. managed care health plans. Study end points included not being in control for CVD risk factors (>or=140 mmHg for systolic blood pressure SBP, >or=3.35 mmol/l for LDL cholesterol, and >or=8.0% for A1C) and the intensity of medication management (number of medication classes) for patients not in control. Logistic regression models with random intercepts were used to adjust probabilities of control and management for demographics, clinical characteristics, and clustering within health plans. RESULTS: There were 1,315 women and 1,575 men with a history of CVD and 3,415 women and 2,516 men without a history of CVD. Among patients with CVD, adjusted estimated probabilities for not being in control and risk differences varied significantly between men and women for SBP (men 41.2%, women 46.6%; risk difference -5.4% 95% CI -9.5 to -1.3) and LDL cholesterol (men 22.4%, women 28.3%; risk difference -5.9% -9.9 to -1.8). There were no significant sex differences in intensity of medication management for patients not in control. In patients without CVD there were no significant differences in control or intensity of medication management. CONCLUSIONS: In diabetic patients with CVD, poorer control of SBP and LDL cholesterol for women may contribute to the sex disparity in CVD mortality trends.
Ferrara et al. (Fri,) conducted a cross-sectional in Diabetes (n=8,821). Male sex vs. Female sex was evaluated on Not being in control for systolic blood pressure (≥140 mmHg) among patients with CVD (Risk difference -5.4%, 95% CI -9.5 to -1.3). Among diabetic patients with CVD, men had significantly lower probabilities of uncontrolled systolic blood pressure (41.2% vs 46.6%) and LDL cholesterol (22.4% vs 28.3%) compared to women.