Wright, A, Kontopantelis, E, Elmsley, R, Buchan, I, Mamas, M ORCID: https://orcid.org/0000-0001-9241-8890, Sattar, N, Ashcroft, D and Rutter, M (2019) Cardiovascular risk and risk factor management in type 2 diabetes: a population-based cohort study assessing sex disparities. Circulation, 139 (24). pp. 2742-2753.

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Abstract

Background:
With recent changes in UK clinical practice for diabetes care, contemporary estimates of sex disparities in cardiovascular risk and risk factor management are needed.

Methods:
In this retrospective cohort study, using the Clinical Practice Research Datalink linked to hospital and death records for people in England, we identified 79,985 patients with incident T2DM between 2006-2013 matched to 386,547 patients without diabetes. Sex-stratified Cox models were used to assess cardiovascular risk.

Results:
Compared to women without T2DM, women with T2DM had a higher cardiovascular event risk (adjusted HR 1.20 [95% CI 1.12-1.28]) with similar corresponding data in men (HR 1.12 [1.06 -1.19]) leading to a non-significant higher relative risk in women (risk ratio 1.07 [0.98-1.17]). However, some important sex differences in the management of risk factors were observed. Compared to men with T2DM, women with T2DM were more likely to be obese, hypertensive and have hypercholesterolaemia but were less likely to be prescribed lipid-lowering medication and ACE inhibitors, especially if they had CVD.

Conclusions:
Compared to men developing T2DM, women with T2DM do not have a significantly higher relative increase in cardiovascular risk, but ongoing sex disparities in prescribing should prompt heightened efforts to improve the standard and equity of diabetes care in women and men.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via American Heart Association at https://doi.org/10.1161/CIRCULATIONAHA.118.039100 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: cardiovascular diseases, database, diabetes mellitus, type 2, primary health care, risk factors
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 13 Mar 2019 16:09
Last Modified: 15 Oct 2019 01:30
URI: http://eprints.keele.ac.uk/id/eprint/6049

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