Women With Diabetes More Prone to Heart Disease Than Men

Coronary heart disease risk and related deaths greater in women with diabetes than in men with diabetes

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Men and women can be diagnosed with diabetes based off of the same signs and symptoms. But that doesn't mean that the condition affects both sexes equally.

A recent review of studies found that women with diabetes were more at risk of developing coronary heart disease compared to men with diabetes.

The researchers also discovered that within each sex, those with diabetes were more at risk for coronary heart disease than those without diabetes.

"Talk to your doctor about heart disease if you have diabetes."

The main author of this study review was Sanne A. E. Peters, PhD, from the Julius Center for Health Sciences and Primary Care at University Medical Center Utrecht in the Netherlands and the Cardiovascular Epidemiology Unit in the Department of Public Health and Primary Care at the University of Cambridge in the United Kingdom.

The review included 64 studies published between January 1, 1966 and February 13, 2013 on the relationship between coronary heart disease (CHD) and diabetes in men and women.

Combined, the studies included 858,507 participants who had a total of 28,203 CHD events. The participants were between the ages of 20 and 107 years old at the beginning of each study, and 42 percent of all the participants were women.

Thirty of the studies came from Asia, 13 came from Europe, 11 came from Australia, New Zealand or Pacific, and 10 were from the United States. Length of follow-up ranged from five to 30 years.

The average prevalence of diabetes at the beginning of each study was 3 percent in women and 5 percent in men.

CHD happens when plaque builds up inside the coronary arteries, reducing the flow of oxygen-rich blood to the heart.

The findings showed that the women with diabetes were 2.82 times more likely to develop CHD than the women who did not have diabetes. Compared to the men without diabetes, men with diabetes were 2.16 times more likely to develop CHD.

The women with diabetes were 44 percent more likely to develop CHD than the men with diabetes.

The authors found that this increased risk between women and men was not affected by the length of follow-up time, amount of CHD events, the ratio of CHD events between men and women, the prevalence of diabetes, or the ratio of diabetes prevalence between men and women in each study.

The analysis was then limited to 52 studies on the association between fatal CHD and diabetes in men and women.

Compared to the women without diabetes, the women with diabetes were 2.83 times more likely to die from CHD. The men with diabetes were 2.04 times more likely than the men without diabetes to die from CHD.

The authors discovered that the women with diabetes were 44 percent more likely to die from CHD than men with diabetes.

Most of the studies adjusted for age, blood pressure, cigarette smoking, body mass index (height to weight ratio) and level of fats in blood. In addition, the difference in diabetes-related risk of CHD between the women and the men was consistent across all age groups and geographical regions of each study.

Dr. Peters and team suggested that the heightened diabetes-related risk of CHD in women compared to men may be due to the women's exposure to heart disease risk factors before they were diagnosed with diabetes.

"Physicians may be more likely to recognize the early symptoms of CHD in men than women because of men's higher absolute risk, and thus sex differences in medication use and risk factor control may still exist. Greater awareness of early symptoms of CHD in women and sex-specific therapeutic risk factor management, irrespective of the presence of diabetes, will be the best way to improve clinical outcomes in both women and men," the authors concluded.

This review was limited because the study design and length, the endpoint definition, amount of adjusting for various factors, information on medication use, and the level of management of other heart disease risk factors differed across studies.

This review was published on May 22 in Diabetologia.

A Niels Stensen Fellowship provided funding.

Review Date: 
May 22, 2014
Last Updated:
May 23, 2014