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Eighteen years of follow-up shows that men are twice as likely to die from heart disease as women. However, this gender gap is markedly reduced when only patients with diabetes are considered.
The reason? Diabetes is a stronger risk factor for heart disease death in women than in men.
In the European Heart Journal, Dr. Ane Cecilie Dale, of the Norwegian University of Science and Technology in Trondheim, and colleagues report data from HUNT 1, a large study in which all adults of Trendelag County, Norway, were invited to participate.
The study involved 74,914 individuals, 2,100 of whom had diabetes. Over an 18-year period, 19,967 subjects died.
When the analysis did not include patients who had diabetes or heart disease at the start of the study, men were 2.20-times more likely to die from heart disease during follow-up than were women.
By contrast, when the analysis included patients with diabetes, the risk in men fell to just 1.25-times that of women. The gender gap disappeared all together when the analysis included patients with diabetes and heart disease at the start of the study.
“We found that the positive association between diabetes and (heart disease) mortality was consistently stronger in women than in men, resulting in a substantial reduction in the mortality gap between genders that is usually observed,” the investigators write.
Diabetes could cause more rapid coronary plaque build-up and other related problems in women, the researchers hypothesize.
“Our results argue for more aggressive (heart disease) risk factor intervention in women with diabetes,” Dale’s team concludes.