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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: Ethnicity
132 codes in list
| Code | Coding system | Description | Entity type | List name | ethnicity_classification | ||
|---|---|---|---|---|---|---|---|
| 9i0..00 | Read | British or mixed British - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i00.00 | Read | White British - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i1..00 | Read | Irish - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i10.00 | Read | White Irish - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2..00 | Read | Other White background - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i20.00 | Read | English - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i21.00 | Read | Scottish - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i22.00 | Read | Welsh - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i26.00 | Read | Cypriot (part not stated) - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i27.00 | Read | Greek - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i28.00 | Read | Greek Cypriot - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i29.00 | Read | Turkish - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2A.00 | Read | Turkish Cypriot - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2B.00 | Read | Italian - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2C.00 | Read | Irish Traveller - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2D.00 | Read | Traveller - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2E.00 | Read | Gypsy/Romany - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2F.00 | Read | Polish - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2H.00 | Read | Commonwealth (Russian) Indep States - ethn categ 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2J.00 | Read | Kosovan - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2K.00 | Read | Albanian - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2P.00 | Read | Other republics former Yugoslavia - ethnic categ 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2R.00 | Read | Oth White European/European unsp/Mixed European 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2S.00 | Read | Other mixed White - ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i2T.00 | Read | Other White or White unspecified ethnic category 2001 census | diagnostic | res72: Ethnicity | White | ||
| 9i3..00 | Read | White and Black Caribbean - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i4..00 | Read | White and Black African - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i5..00 | Read | White and Asian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i6..00 | Read | Other Mixed background - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i60.00 | Read | Black and Asian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i61.00 | Read | Black and Chinese - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i62.00 | Read | Black and White - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i63.00 | Read | Chinese and White - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i64.00 | Read | Asian and Chinese - ethnic category 2001 census | diagnostic | res72: Ethnicity | Mixed | ||
| 9i7..00 | Read | Indian or British Indian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9i8..00 | Read | Pakistani or British Pakistani - ethnic category 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9i9..00 | Read | Bangladeshi or British Bangladeshi - ethn categ 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9iA..00 | Read | Other Asian background - ethnic category 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9iA3.00 | Read | East African Asian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iA4.00 | Read | Sri Lankan - ethnic category 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9iA5.00 | Read | Tamil - ethnic category 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9iA6.00 | Read | Sinhalese - ethnic category 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9iA7.00 | Read | Caribbean Asian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iA8.00 | Read | British Asian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9iA9.00 | Read | Mixed Asian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9iB..00 | Read | Caribbean - ethnic category 2001 census | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9iC..00 | Read | African - ethnic category 2001 census | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9iD..00 | Read | Other Black background - ethnic category 2001 census | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9iD0.00 | Read | Somali - ethnic category 2001 census | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9iD1.00 | Read | Nigerian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9iD2.00 | Read | Black British - ethnic category 2001 census | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9iE..00 | Read | Chinese - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iF..00 | Read | Other - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iF0.00 | Read | Vietnamese - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iF1.00 | Read | Japanese - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iF2.00 | Read | Filipino - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iF3.00 | Read | Malaysian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iF9.00 | Read | Arab - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iFA.00 | Read | North African - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iFB.00 | Read | Mid East (excl Israeli; Iranian & Arab) - eth cat 2001 cens | diagnostic | res72: Ethnicity | Other | ||
| 9iFD.00 | Read | Iranian - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iFE.00 | Read | Kurdish - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iFG.00 | Read | Latin American - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iFH.00 | Read | South and Central American - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9iFJ.00 | Read | Mauritian/Seychellois/Maldivian/St Helena eth cat 2001census | diagnostic | res72: Ethnicity | Other | ||
| 9iFK.00 | Read | Any other group - ethnic category 2001 census | diagnostic | res72: Ethnicity | Other | ||
| 9S1..00 | Read | White | diagnostic | res72: Ethnicity | White | ||
| 9S10.00 | Read | White British | diagnostic | res72: Ethnicity | White | ||
| 9S11.00 | Read | White Irish | diagnostic | res72: Ethnicity | White | ||
| 9S13.00 | Read | White Scottish | diagnostic | res72: Ethnicity | White | ||
| 9S14.00 | Read | Other white British ethnic group | diagnostic | res72: Ethnicity | White | ||
| 9S2..00 | Read | Black Caribbean | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S3..00 | Read | Black African | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S4..00 | Read | Black; other; non-mixed origin | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S41.00 | Read | Black British | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S42.00 | Read | Black Caribbean/W.I./Guyana | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S42.11 | Read | Black Caribbean | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S42.12 | Read | Black West Indian | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S42.13 | Read | Black Guyana | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S43.00 | Read | Black N African/Arab/Iranian | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S43.11 | Read | Black North African | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S43.12 | Read | Black Arab | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S43.13 | Read | Black Iranian | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S44.00 | Read | Black - other African country | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S45.00 | Read | Black E Afric Asia/Indo-Caribb | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S45.11 | Read | Black East African Asian | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S45.12 | Read | Black Indo-Caribbean | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S47.00 | Read | Black - other Asian | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S48.00 | Read | Black Black - other | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S5..00 | Read | Black - other; mixed | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9S51.00 | Read | Other Black - Black/White orig | diagnostic | res72: Ethnicity | Mixed | ||
| 9S52.00 | Read | Other Black - Black/Asian orig | diagnostic | res72: Ethnicity | Mixed | ||
| 9S6..00 | Read | Indian | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9S7..00 | Read | Pakistani | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9S8..00 | Read | Bangladeshi | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9S9..00 | Read | Chinese | diagnostic | res72: Ethnicity | Other | ||
| 9SA..00 | Read | Other ethnic non-mixed (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SA2.00 | Read | Brit. ethnic minor. unsp (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SA3.00 | Read | Caribbean I./W.I./Guyana (NMO) | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9SA3.11 | Read | Caribbean Island (NMO) | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9SA3.12 | Read | West Indian (NMO) | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9SA3.13 | Read | Guyana (NMO) | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9SA4.00 | Read | N African Arab/Iranian (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SA4.11 | Read | North African Arab (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SA4.12 | Read | Iranian (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SA5.00 | Read | Other African countries (NMO) | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9SA6.00 | Read | E Afric Asian/Indo-Carib (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SA6.11 | Read | East African Asian (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SA6.12 | Read | Indo-Caribbean (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SA7.00 | Read | Indian sub-continent (NMO) | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9SA8.00 | Read | Other Asian (NMO) | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9SA9.00 | Read | Irish (NMO) | diagnostic | res72: Ethnicity | White | ||
| 9SAA.00 | Read | Greek/Greek Cypriot (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SAA.11 | Read | Greek (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SAA.12 | Read | Greek Cypriot (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SAB.00 | Read | Turkish/Turkish Cypriot (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SAB.11 | Read | Turkish (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SAB.12 | Read | Turkish Cypriot (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SAC.00 | Read | Other European (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SAD.00 | Read | Other ethnic NEC (NMO) | diagnostic | res72: Ethnicity | Other | ||
| 9SB..00 | Read | Other ethnic; mixed origin | diagnostic | res72: Ethnicity | Mixed | ||
| 9SB1.00 | Read | Other ethnic; Black/White orig | diagnostic | res72: Ethnicity | Mixed | ||
| 9SB2.00 | Read | Other ethnic; Asian/White orig | diagnostic | res72: Ethnicity | Mixed | ||
| 9SB3.00 | Read | Other ethnic; mixed white orig | diagnostic | res72: Ethnicity | Mixed | ||
| 9SB4.00 | Read | Other ethnic; other mixed orig | diagnostic | res72: Ethnicity | Mixed | ||
| 9SB5.00 | Read | Black Caribbean and White | diagnostic | res72: Ethnicity | Mixed | ||
| 9SB6.00 | Read | Black African and White | diagnostic | res72: Ethnicity | Mixed | ||
| 9SC..00 | Read | Vietnamese | diagnostic | res72: Ethnicity | Other | ||
| 9SG..00 | Read | Other black ethnic group | diagnostic | res72: Ethnicity | Black/Black British | ||
| 9SH..00 | Read | Other Asian ethnic group | diagnostic | res72: Ethnicity | Asian/British Asian | ||
| 9SI..00 | Read | Irish traveller | diagnostic | res72: Ethnicity | White | ||
| 9SJ..00 | Read | Other ethnic group | diagnostic | res72: Ethnicity | Other |
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