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Research article:
Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes: A Population-Based Cohort Study Assessing Sex Disparities
Reference:
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
- Link to article
- 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.
- Author for correspondence
- Alison Wright
- Email for correspondence
- alison.wright@manchester.ac.uk
Code list: res72: CKD
58 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 1Z10.00 | Read | Chronic kidney disease stage 1 | diagnostic | res72: CKD | |||
| 1Z11.00 | Read | Chronic kidney disease stage 2 | diagnostic | res72: CKD | |||
| 1Z12.00 | Read | Chronic kidney disease stage 3 | diagnostic | res72: CKD | |||
| 1Z13.00 | Read | Chronic kidney disease stage 4 | diagnostic | res72: CKD | |||
| 1Z14.00 | Read | Chronic kidney disease stage 5 | diagnostic | res72: CKD | |||
| 1Z15.00 | Read | Chronic kidney disease stage 3A | diagnostic | res72: CKD | |||
| 1Z16.00 | Read | Chronic kidney disease stage 3B | diagnostic | res72: CKD | |||
| 1Z17.00 | Read | Chronic kidney disease stage 1 with proteinuria | diagnostic | res72: CKD | |||
| 1Z17.11 | Read | CKD stage 1 with proteinuria | diagnostic | res72: CKD | |||
| 1Z18.00 | Read | Chronic kidney disease stage 1 without proteinuria | diagnostic | res72: CKD | |||
| 1Z18.11 | Read | CKD stage 1 without proteinuria | diagnostic | res72: CKD | |||
| 1Z19.00 | Read | Chronic kidney disease stage 2 with proteinuria | diagnostic | res72: CKD | |||
| 1Z19.11 | Read | CKD stage 2 with proteinuria | diagnostic | res72: CKD | |||
| 1Z1a.00 | Read | CKD with GFR category G4 & albuminuria category A1 | diagnostic | res72: CKD | |||
| 1Z1A.00 | Read | Chronic kidney disease stage 2 without proteinuria | diagnostic | res72: CKD | |||
| 1Z1A.11 | Read | CKD stage 2 without proteinuria | diagnostic | res72: CKD | |||
| 1Z1b.00 | Read | CKD with GFR category G4 & albuminuria category A2 | diagnostic | res72: CKD | |||
| 1Z1B.00 | Read | Chronic kidney disease stage 3 with proteinuria | diagnostic | res72: CKD | |||
| 1Z1B.11 | Read | CKD stage 3 with proteinuria | diagnostic | res72: CKD | |||
| 1Z1c.00 | Read | CKD with GFR category G4 & albuminuria category A3 | diagnostic | res72: CKD | |||
| 1Z1C.00 | Read | Chronic kidney disease stage 3 without proteinuria | diagnostic | res72: CKD | |||
| 1Z1C.11 | Read | CKD stage 3 without proteinuria | diagnostic | res72: CKD | |||
| 1Z1d.00 | Read | CKD with GFR category G5 & albuminuria category A1 | diagnostic | res72: CKD | |||
| 1Z1D.00 | Read | Chronic kidney disease stage 3A with proteinuria | diagnostic | res72: CKD | |||
| 1Z1D.11 | Read | CKD stage 3A with proteinuria | diagnostic | res72: CKD | |||
| 1Z1e.00 | Read | CKD with GFR category G5 & albuminuria category A2 | diagnostic | res72: CKD | |||
| 1Z1E.00 | Read | Chronic kidney disease stage 3A without proteinuria | diagnostic | res72: CKD | |||
| 1Z1E.11 | Read | CKD stage 3A without proteinuria | diagnostic | res72: CKD | |||
| 1Z1f.00 | Read | CKD with GFR category G5 & albuminuria category A3 | diagnostic | res72: CKD | |||
| 1Z1F.00 | Read | Chronic kidney disease stage 3B with proteinuria | diagnostic | res72: CKD | |||
| 1Z1F.11 | Read | CKD stage 3B with proteinuria | diagnostic | res72: CKD | |||
| 1Z1G.00 | Read | Chronic kidney disease stage 3B without proteinuria | diagnostic | res72: CKD | |||
| 1Z1G.11 | Read | CKD stage 3B without proteinuria | diagnostic | res72: CKD | |||
| 1Z1H.00 | Read | Chronic kidney disease stage 4 with proteinuria | diagnostic | res72: CKD | |||
| 1Z1H.11 | Read | CKD stage 4 with proteinuria | diagnostic | res72: CKD | |||
| 1Z1J.00 | Read | Chronic kidney disease stage 4 without proteinuria | diagnostic | res72: CKD | |||
| 1Z1J.11 | Read | CKD stage 4 without proteinuria | diagnostic | res72: CKD | |||
| 1Z1K.00 | Read | Chronic kidney disease stage 5 with proteinuria | diagnostic | res72: CKD | |||
| 1Z1K.11 | Read | CKD stage 5 with proteinuria | diagnostic | res72: CKD | |||
| 1Z1L.00 | Read | Chronic kidney disease stage 5 without proteinuria | diagnostic | res72: CKD | |||
| 1Z1L.11 | Read | CKD stage 5 without proteinuria | diagnostic | res72: CKD | |||
| 1Z1M.00 | Read | CKD with GFR category G1 & albuminuria category A1 | diagnostic | res72: CKD | |||
| 1Z1N.00 | Read | CKD with GFR category G1 & albuminuria category A2 | diagnostic | res72: CKD | |||
| 1Z1P.00 | Read | CKD with GFR category G1 & albuminuria category A3 | diagnostic | res72: CKD | |||
| 1Z1Q.00 | Read | CKD with GFR category G2 & albuminuria category A1 | diagnostic | res72: CKD | |||
| 1Z1R.00 | Read | CKD with GFR category G2 & albuminuria category A2 | diagnostic | res72: CKD | |||
| 1Z1S.00 | Read | CKD with GFR category G2 & albuminuria category A3 | diagnostic | res72: CKD | |||
| 1Z1T.00 | Read | CKD with GFR category G3a & albuminuria category A1 | diagnostic | res72: CKD | |||
| 1Z1V.00 | Read | CKD with GFR category G3a & albuminuria category A2 | diagnostic | res72: CKD | |||
| 1Z1W.00 | Read | CKD with GFR category G3a & albuminuria category A3 | diagnostic | res72: CKD | |||
| 1Z1X.00 | Read | CKD with GFR category G3b & albuminuria category A1 | diagnostic | res72: CKD | |||
| 1Z1Y.00 | Read | CKD with GFR category G3b & albuminuria category A2 | diagnostic | res72: CKD | |||
| 1Z1Z.00 | Read | CKD with GFR category G3b & albuminuria category A3 | diagnostic | res72: CKD | |||
| K051.00 | Read | Chronic kidney disease stage 1 | diagnostic | res72: CKD | |||
| K052.00 | Read | Chronic kidney disease stage 2 | diagnostic | res72: CKD | |||
| K053.00 | Read | Chronic kidney disease stage 3 | diagnostic | res72: CKD | |||
| K054.00 | Read | Chronic kidney disease stage 4 | diagnostic | res72: CKD | |||
| K055.00 | Read | Chronic kidney disease stage 5 | diagnostic | res72: CKD |
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