Heart Problems Worse For Diabetic Women, 34% More Likely To Die

"The female advantage with fewer cardiovascular events than in men at younger ages is attenuated once a woman has the diagnosis of diabetes," Dr. Anna Norhammar and associates write in the journal Heart. In fact, they add, "the risk is increased about twofold in men and up to four times in women."

Their goal in the current study was to identify gender-related differences in prognosis, risk factors, or treatment among 25,555 patients younger than 65 years old who were treated between 1995 and 2002 for a heart attack.

Twenty-three percent of the patients were women and 21 percent of women and 16 percent of men had diabetes.

During roughly 4 years of follow-up, diabetic women were 34 percent more likely to die than were diabetic men.

Compared with the male patients, female patients had higher rates of high blood pressure and heart failure and were more likely to smoke.

Fewer women than men had undergone bypass surgery or angioplasty prior to their first heart attack, and women were less likely to be treated with medications called beta-blockers and ACE inhibitors.

Nevertheless, Norhammar, at Karolinska University Hospital in Stockholm, and her team attribute the higher death rate in women to risk factors rather than treatment differences.

By contrast, there were no significant gender-related differences in death rates in older people, or among subjects without diabetes.

"The present observation makes further study of the impact of improved risk factor management in this particular group of relatively young, easily identifiable, high-risk patients important," the authors conclude, "together with attempts to initiate treatment and cardiac investigations before their first (heart attack) or the onset of heart failure."
Heart, November 2008.