Women's heart and diabetes
Currently, it has been proven that diabetes mellitus and heart failure are conditions that accompany each other. Diabetes increases the risk of not only heart failure, but also death after diagnosis. Heart failure is the second most common cardiovascular disease in patients with type 2 diabetes mellitus - it happens more often than myocardial infarction or stroke. Experts expect an increase in the incidence of heart failure, which makes prevention and timely treatment necessary.
The accumulated data indicate that there are significant differences in the degree of risk of a number of cardiovascular diseases associated with diabetes, depending on the gender of the patient. Previous studies have shown that diabetes increases the risk of coronary heart disease (CHD) and stroke, as well as non-vascular complications, including dementia and cancer, to a greater extent in women compared to men. In a new study, Dr. Toshiaki Okuma from the University of New South Wales, Sydney, and Dr. Sunn Peters from the University of Oxford, UK, and colleagues studied possible sex differences in the risk of heart failure associated with diabetes.
The analysis included observational cohort studies from the PubMed database containing information on the risk of heart failure in both sexes. Studies whose participants suffered from underlying diseases were excluded, as well as if data were available only for one gender.
The researchers calculated the relative risks of fatal or non-fatal heart failure for women and men by comparing people with and without diabetes.
Of the 5,991 articles found, 14 studies provided useful data on gender differences in the risk of heart failure in diabetics. Two large cohort studies were devoted to type 1 diabetes mellitus (a total of 3,284,123 people and 95,129 cases of heart failure). Data on type 2 diabetes mellitus and heart failure were obtained from 13 studies involving 47 cohorts (11,925,128 people and 249,560 cases of heart failure)
Type 1 diabetes was associated with an increased risk of heart failure in women by 5.15 times, and in men by 3.47 times, that is, the relative risk of heart failure in women was almost 1.5 times higher than in men. For type 2 diabetes, the difference was relatively small: the risk of heart failure in women compared to participants without diabetes was 1.95 times, and in men – 1.74 times, that is, in women, the relative risk of heart failure is 9% higher compared to men.
The authors suggest several possible explanations for the increased risk of heart failure in women with diabetes mellitus. Firstly, diabetes can lead to a higher risk of coronary heart disease in women than in men, and coronary heart disease is the main cause of heart failure in patients with type 2 diabetes mellitus. Previously, it was shown that the risk of coronary heart disease associated with diabetes is higher in women. Secondly, women are often worse at controlling blood glucose levels. Another possible cause is related to a longer blood glucose threshold before the final diagnosis of diabetes (a condition known as prediabetes) in women compared to men. This period can last up to two years or more in women and is associated with dysfunction of the cardiovascular system. Finally, other risk factors for cardiovascular diseases, which are more common in women than in men, may cause a higher risk of complications in the form of heart failure.
In terms of type of diabetes, the risk in women was higher with type 1 diabetes compared to type 2. The reason for this difference is unclear, but the authors suggest that the above-mentioned sex differences partially play a role in the correlation between diabetes and coronary heart disease.
This meta-analysis includes a large number of patients: 14 studies with 12 million participants. But there are drawbacks, for example, the use of unmeasurable factors in the analyzed studies and the fact that potentially useful data on the duration of diabetes, blood sugar control, the use of drugs that reduce glucose levels or the type of heart failure were not available. The risk of premature death was higher in men with diabetes than in women, which reduces the likelihood of developing heart failure in men – they simply did not live to see it.
The authors write that the results highlight the importance of intensive prevention and treatment of diabetes for women and men, as well as the need for further research that would allow understanding the mechanisms underlying higher risk in women (especially with type 1 diabetes).
Article by T. Ohkuma et al. Diabetes as a risk factor for heart failure in women and men: a systematic review and meta-analysis of 47 cohorts including 12 million individuals published in Springer magazine.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru according to the materials Diabetologia: Diabetes increases the risk of heart failure more in women than men.