Type 2 diabetes increased the risk of major CHD events more in women (HR 9.5; 95% CI 5.5-16.9) than in men (HR 2.8; 95% CI 2.0-3.7), partly due to a heavier risk factor burden in diabetic women.
Cohort (n=2,131)
Does type 2 diabetes confer a higher relative risk of coronary heart disease in women compared with men?
Type 2 diabetes confers a substantially higher relative risk of major coronary heart disease events in women compared to men, partly driven by a heavier risk factor burden and greater impact of blood pressure and atherogenic dyslipidemia.
Effect estimate: HR 9.5 in women, 2.8 in men (95% CI 5.5-16.9 in women, 2.0-3.7 in men)
OBJECTIVE: To explain the stronger effect of type 2 diabetes on the risk of coronary heart disease (CHD) in women compared with men. RESEARCH DESIGN AND METHODS: The study population consisted of 1,296 nondiabetic subjects and 835 type 2 diabetic subjects aged 45-64 years without cardiovascular disease. The end points were CHD death and a major CHD event (CHD death or nonfatal myocardial infarction). The follow-up time was 13 years. RESULTS: Major CHD event rate per 1,000 person-years was 11.6 in nondiabetic men, 1.8 in nondiabetic women, 36.3 in diabetic men, and 31.6 in diabetic women. The diabetes-related hazard ratio for a major CHD event from the Cox model, adjusted for age and area of residence, was 2.9 (95% CI 2.2-3.9) in men and 14.4 (8.4-24.5) in women, and after further adjustment for cardiovascular risk factors, 2.8 (2.0-3.7) and 9.5 (5.5-16.9), respectively. The burden of conventional risk factors in the presence of diabetes was greater in women than in men at baseline. Prospectively, elevated blood pressure, low HDL cholesterol, and high triglycerides contributed to diabetes-related CHD risk more in women than in men. However, after adjusting for conventional risk factors, a substantial proportion of diabetes-related CHD risk remained unexplained in both genders. CONCLUSIONS: The stronger effect of type 2 diabetes on the risk of CHD in women compared with men was in part explained by a heavier risk factor burden and a greater effect of blood pressure and atherogenic dyslipidemia in diabetic women.
Juutilainen et al. (2004) conducted a cohort in Type 2 diabetes (n=2,131). Type 2 diabetes vs. Nondiabetic subjects was evaluated on Major CHD event (CHD death or nonfatal myocardial infarction) (HR 9.5 in women, 2.8 in men, 95% CI 5.5-16.9 in women, 2.0-3.7 in men). Type 2 diabetes increased the risk of major CHD events more in women (HR 9.5; 95% CI 5.5-16.9) than in men (HR 2.8; 95% CI 2.0-3.7), partly due to a heavier risk factor burden in diabetic women.