While it is well established that individuals with diabetes are at higher risk for cardiovascular disease, a new scientific statement from the American Heart Association claims this risk may be significantly greater for women with the condition.

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Women with type 2 diabetes are twice as likely to develop coronary heart disease than men, according to the new statement.

Published in the journal Circulation, the statement also says women with type 2 diabetes may need to take more action than men to lower their risk for heart attack and stroke.

Type 2 diabetes accounts for around 90-95% of all diabetes cases in the US, affecting men and women at similar rates; around 12.6 million women and 13 million men aged 20 and older have the condition.

According to the American Heart Association (AHA), adults with diabetes are around two to four times more likely to have heart disease or stroke than those without diabetes, primarily because diabetes patients are at greater risk for high blood pressure, high cholesterol and obesity – key risk factors for cardiovascular problems.

Increasingly, however, studies have suggested that cardiovascular risks among adults with diabetes may vary by sex, and such findings are reflected in the new AHA scientific statement.

Judith G. Regensteiner, PhD, chair of the AHA’s statement writing group and professor of medicine and director of the Center for Women’s Health Research at the University of Colorado School of Medicine, and coauthors claim that women with type 2 diabetes are more than twice as likely to develop coronary heart disease – the most common form of heart disease – than men.

Fast facts about diabetes
  • Around 29.1 million people in the US have diabetes – 1 in 11 Americans
  • Around 86 million adults in the US have pre-diabetes
  • As well as heart disease, diabetes can cause blindness, kidney failure and lower-extremity amputations, among other serious health complications.
  • Learn more about diabetes

Black and Hispanic women with type 2 diabetes are also disproportionately affected by coronary heart disease compared with men, the authors note.

Women with type 2 diabetes are more likely to have heart attacks earlier in life than men and are more likely to die after a first heart attack, according to the statement.

Compared with men with type 2 diabetes, women with the condition may need to engage in more frequent and intense exercise in order to lower their risk for cardiovascular disease.

Regensteiner and colleagues also point to differences between men and women with type 2 diabetes in the use of strategies to protect cardiovascular health. For example, women were less likely than men to use cholesterol-lowering drugs – such as statins – blood pressure-lowering medications and aspirin.

Women with type 2 diabetes were also less likely to have their blood pressure under control than men and were less likely to undergo procedures to open blocked arteries, such as angioplasty.

Additionally, the statement authors found women with type 2 diabetes develop the condition based on sex-specific variances, including the presence of polycystic ovary syndrome (PCOS) and gestational diabetes.

Commenting on what the statement shows, Regensteiner says:

Cardiovascular disease may be more deadly for women with type 2 diabetes than it is for men.

While we don’t fully understand how the inherent hormonal differences between men and women affect risk, we do know that some risk factors for heart disease and stroke affect women differently than men and there are disparities in how these risk factors are treated.”

The authors say further research is required in order to gain a better understanding of why women with type 2 diabetes are at greater cardiovascular risk than men, as well as the reasons why women of certain ethnicities appear to be at greater risk.

“To improve health equity in women and men with diabetes, we need to understand and improve both the biological reasons for the disparities and also control cardiovascular risk factors equally in both women and men,” explains Regensteiner. “This statement is a call for action to do the compelling research that is so important for all people with diabetes.”

Last month, Medical News Today reported on a study that linked exposure to air pollution among women with type 2 diabetes to increased risk of cardiovascular disease and stroke.