How does diabetes influence CVD risk in men vs women?

Women who develop diabetes show less favourable changes in cardiovascular disease (CVD) risk factors, such that blood pressure (BP) and lipid levels deteriorate rapidly compared with their male counterparts, a study has found.

The study included 4,893 participants aged 18–30 years at enrolment into the Coronary Artery Risk Development in Young Adults Study. At baseline, women had lower BP and fasting glucose as well as better lipid profiles than men, except that black women had higher total and low-density lipoprotein (LDL) cholesterol levels than black men.

Over a median follow-up of 31 years, 827 participants developed diabetes. The cumulative incidence was highest among black women and lowest among white women. Black and white women developed diabetes at younger ages than men. The mean 10-year predicted atherosclerosis CVD risk among diabetes patients were 3.2 percent for white women, 6.7 percent for black women, 8.1 percent for white men, and 12.6 percent for black men.

Progression in most CVD risk factors did not differ by sex before diabetes. However, systolic BP, diastolic BP, total cholesterol, LDL cholesterol, and triglycerides worsened more rapidly after the diagnosis of diabetes in women than men.

On Cox analysis, incident diabetes conferred a higher CVD hazard (hazard ratio, 1.45, 95 percent confidence interval, 1.07–1.96). But this association was not modified by sex (p_interaction=0.8).

In light of the findings, researchers underscored the need for interventions that mitigate these adverse changes in women who have recently been diagnosed with diabetes.