The increased risk of cardiovascular disease (CVD) upon developing type 2 diabetes is similar in men and women, show data from a large UK-based study of newly diagnosed patients.

The new findings contradict prior studies and are the first to show that the proportionate CVD risk increase upon developing type 2 diabetes is similar between the sexes, with a nonsignificant relative risk ratio of 1.07.

However, women are still prescribed fewer therapies than men — including statins and angiotensin-converting-enzyme (ACE) inhibitors — raising concerns that women continue to receive suboptimal disease management.

That observation highlights the need for closer adherence to prescribing guidance, continued routine surveillance for gender-related prescribing biases, and possibly greater uptake of professional-based interventions in the community, note the study authors. The study was published online April 15 in Circulation.

In an interview with Medscape Medical News, senior author Martin Rutter, MD, who is senior lecturer in cardiometabolic medicine at the University of Manchester, England, explained that historical studies show that women have a proportionately greater increase in their CVD risk upon developing diabetes. "Now, in the UK, we've shown that this has been negated, with no statistically significant difference in CVD risk increase between women and men."

Rutter added that the similarity in the degree of CVD risk increase found in men and women might be reflected by the pay-for-performance initiative for general practitioners aimed at improving CVD risk management in type 2 diabetes known as the Quality and Outcomes Framework.

"Managing CVD risk factors and managing diabetes is remunerated in terms of achievement. This system of care might be more equitable for women than historical systems," he said.

However, he stresses that an imbalance in prescribing to counter CVD risk factors remains, with women receiving fewer medications. "Women still appear to be compromised disproportionately."

Vasan Ramachandran, MD, professor of medicine and epidemiology, Boston University School of Medicine and Boston University School of Public Health, and principal investigator of the Framingham Heart Study, commented on the study and its findings.

"It is intriguing that [major adverse cardiovascular event (MACE)] risk is similar in men and women with diabetes mellitus, even though women were less well treated in terms of their other risk factors, and that prior studies reported women had about 25% - 50% higher risk of CVD compared to men," he remarked.

"Despite the lack of sex-related differences in MACE risk, women with diabetes mellitus were more likely to be obese, hypertensive and have hypercholesterolemia, yet less likely to be treated with a statin or blood pressure-lowering medication; women who also had prior CVD were also less likely to be treated with antiplatelet drugs," Ramachandran pointed out.

Data From Nearly 80,000 Cases

CVD risk is increased in all people with type 2 diabetes. While men with the disease have a higher overall risk of CVD than women, prior meta-analyses have shown significant relative risk ratios in women compared with men for fatal coronary heart disease, incident coronary heart disease stroke, and all fatal atherosclerotic disease.

Medscape Medical News