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Research article:

Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes: A Population-Based Cohort Study Assessing Sex Disparities


Alison K. Wright, Evangelos Kontopantelis, Richard Emsley, Iain Edward Buchan, Mamas A. Mamas, Naveed Sattar, Darren M. Ashcroft, and Martin K. Rutter(2019) Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes: A Population-Based Cohort Study Assessing Sex Disparities. Circulation, doi: 10.1161/CIRCULATIONAHA.118.039100

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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.
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Alison Wright
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Res72: Diabetes Download this codelist
Res72: MACE Download this codelist
Res72: Obesity Download this codelist
Res72: Smoking Download this codelist
Res72: History of pregnancy Download this codelist
Res72: Antidiabetics Download this codelist
Res72: Hormone replacement therapy Download this codelist
Res72: Oral contraceptive Download this codelist
Res72: Lipid lowering agents Download this codelist
Res72: Antiplatelets Download this codelist
Res72: Antihypertensives Download this codelist
Res72: Ethnicity Download this codelist
Res72: CKD Download this codelist
Res72: Charlson comorbidities Download this codelist
Res72: Microvascular complications Download this codelist
Res72: Interventions Download this codelist

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