Women with Diabetes Had Greater Heart Disease Risk Than Men

Type 2 diabetes patients of both genders are prone to heart problems but the risk may be higher for women

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

(RxWiki News) People with diabetes are at risk for heart disease. One gender may face a higher risk than the other.

A recent study found that women with type 2 diabetes had higher systolic blood pressures and higher LDL ("bad") cholesterol levels than men.

Both high blood pressure and high LDL cholesterol are risk factors for heart disease.

"If you have diabetes, discuss your heart health with a cardiologist."

Joni Strom Williams, MD, MPH, of the Center for Health Disparities Research in Charleston, South Carolina, led this study.

The risk of death from cardiovascular disease is two to four times higher among people with diabetes, Dr. Strom Williams and colleagues noted. These researchers wanted to see if that risk was greater for one gender than the other.

From May to August 2011, the researchers recruited 680 adults (383 men and 297 women) with type 2 diabetes from three primary care settings in the southeastern United States. They looked at individual and group (women versus men) risk factors for cardiovascular disease (CVD).

These risk factors included glycosylated hemoglobin A1c (a blood test that shows average blood sugar levels over a six- to 12-week period), blood pressure and low-density lipoprotein (LDL) cholesterol levels.

The goal was for all subjects to have an A1c of less than 7, a blood pressure lower than 130/80, and LDL cholesterol lower than 100 mg/dL. The healthiest participants had met all goals at the same time.

In their study, they found that systolic (the top number) blood pressure and LDL cholesterol was significantly higher among women than men, the research showed.

Women tended to have a systolic blood pressure of 134, while the men maintained a systolic blood pressure of 130.

Women also had higher LDL cholesterol, although it was lower than the goal at 99.7 mg/dL. Men had LDL cholesterol levels of about 87.6 mg/dL.

The women’s average A1c was 7.9 versus 7.8 for men.

In terms of overall control, 12.4 percent of those in the study managed to obtain control of all three factors. However, 17.3 percent of men had complete control, versus only 5.9 percent of women.

This difference between genders is a concern, the authors wrote, because women are typically treated less aggressively for heart disease and are taught less about modifiable risk factors (factors they have control over, such as diet or exercise).

Women have inflammation in every cell in their body due to a drop in estrogen as they age, and this may be the reason that women in this study had a higher overall cardiovascular risk factor score than men, according to Dr. Barry Sears, President of the non-profit Inflammation Research Foundation in Marblehead, MA and creator of The Zone Diet.

“This increased inflammation would increase the levels of insulin resistance [when the body doesn't properly use the hormone insulin] relative to the men. Such an increased insulin resistance would explain why the HbA1c levels, blood pressure, and LDL cholesterol levels were higher the in the women than the men," Dr. Sears told dailyRx News.

“It would have been nice to have a confirmation of this increased insulin resistance from higher levels of BMI and increased triglyceride levels (both very sensitive to insulin resistance), but the data collection methods used by the researchers would not have given that information," Dr. Sears said.

The study authors wrote that their findings suggest more research is needed. “These results point to the need for more research on composite CVD risk factor control in women with diabetes. Future research must focus on understanding the potential mediators causing gender differences in control," they wrote.

“It is imperative that women are informed about CVD risk factors, educated on how to reduce them, and aggressively treated to avoid adverse outcomes,” they concluded.

This study appeared May 15 in Diabetes Technology and Therapeutics.

The authors did not declare any conflicts of interest.

Review Date: 
May 19, 2014
Last Updated:
May 19, 2014