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Women with Diabetes at Higher Risk for Heart Attack than Men

Gender-driven “risk window” found to mostly occur around menopausal age.

Previous studies have shown that women with diabetes have a higher risk of cardiovascular events than men with diabetes when compared with their respective non-diabetic counterparts. However, it is unclear when this risk begins or how long it lasts. Researchers conducted a retrospective follow-up study looking at cohorts from 2005 to 2012 of diabetic patients and compared between genders the effect of age on diabetes-related excess risk of hospitalization for acute MI, ischemic stroke, and congestive heart failure.

The data was pooled from all hospitals in Tuscany from 2005 to 2012. Researchers included the general population registry of inhabitants in Tuscany and a dataset containing the registry of all known patients with diabetes. Results showed that in a total of 3,192,203 inhabitants aged more than 16 years (47% males), there were 24,605 hospitalizations for acute MI (16,251 in men and 8,354 in women), 26,953 for ischemic stroke (14,848 in men and 12,105 in women), and 17,628 for congestive heart failure (8,403 in men and 9,225 in women).

After adjusting for age, the diabetes-related excess risk was overall significantly higher in women than in men hospitalized for acute MI (2.63 times increased risk vs 1.96 times for men; a relative increase risk of 34% in women). Risk for ischemic stroke and congestive heart failure was similar in men and women. Diabetic women hospitalized for acute MI had a significantly higher excess risk than diabetic men, along the entire age interval between 45-54 years up to age 75-84 years, with the highest difference found in age class 45-54 years (increased risk 5.83 times in women vs. 2.88 in men). In patients hospitalized for ischemic stroke and congestive heart failure, diabetic women had an excess risk higher than men from age 55-64 years up to 75-84 years, with the highest difference in age 55-64yr in both (4.14 v 3.05 for ischemic stroke and 6.83 v 4.11 for congestive heart failure).

The results of this study shows that with respect to acute MI, diabetic women are more at risk, compared to diabetic men with a gender-driven “risk window,” which mostly occurs around menopausal age (45 years onwards).

Practice Pearls:

  • The diabetes-related excess risk was overall significantly higher in women than in men hospitalized for acute MI (2.63 times increased risk vs 1.96 times for men; a relative increase risk of 34% in women).
  • Diabetic women hospitalized for acute MI had a significantly higher excess risk than diabetic men, along the entire age interval between 45-54 years up to age 75-84 years, with the highest difference found in age class 45-54 years (increased risk 5.83 times in women vs. 2.88 in men)
  • With respect to acute MI, diabetic women are more at risk, compared to diabetic men with a gender-driven “risk window,” which mostly occurs around menopausal age (45 years onwards).

Schieszer, John. “Cardiovascular Event Risk Higher in Women vs. Men With Diabetes.” Endocrinology Advisor. Haymarket Media, Inc. 17 Sep 2015. Web. 24 Sep 2015.