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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: MACE
127 codes in list
| Code | Coding system | Description | Entity type | List name | MACE_type | ||
|---|---|---|---|---|---|---|---|
| 323..00 | Read | ECG: myocardial infarction | diagnostic | res72: MACE | MI | ||
| 323Z.00 | Read | ECG: myocardial infarct NOS | diagnostic | res72: MACE | MI | ||
| G30..00 | Read | Acute myocardial infarction | diagnostic | res72: MACE | MI | ||
| G300.00 | Read | Acute anterolateral infarction | diagnostic | res72: MACE | MI | ||
| G301.00 | Read | Other specified anterior myocardial infarction | diagnostic | res72: MACE | MI | ||
| G301000 | Read | Acute anteroapical infarction | diagnostic | res72: MACE | MI | ||
| G301100 | Read | Acute anteroseptal infarction | diagnostic | res72: MACE | MI | ||
| G30..12 | Read | Coronary thrombosis | diagnostic | res72: MACE | MI | ||
| G30..13 | Read | Cardiac rupture following myocardial infarction (MI) | diagnostic | res72: MACE | MI | ||
| G30..15 | Read | MI - acute myocardial infarction | diagnostic | res72: MACE | MI | ||
| G30..16 | Read | Thrombosis - coronary | diagnostic | res72: MACE | MI | ||
| G30..17 | Read | Silent myocardial infarction | diagnostic | res72: MACE | MI | ||
| G301z00 | Read | Anterior myocardial infarction NOS | diagnostic | res72: MACE | MI | ||
| G302.00 | Read | Acute inferolateral infarction | diagnostic | res72: MACE | MI | ||
| G303.00 | Read | Acute inferoposterior infarction | diagnostic | res72: MACE | MI | ||
| G304.00 | Read | Posterior myocardial infarction NOS | diagnostic | res72: MACE | MI | ||
| G305.00 | Read | Lateral myocardial infarction NOS | diagnostic | res72: MACE | MI | ||
| G306.00 | Read | True posterior myocardial infarction | diagnostic | res72: MACE | MI | ||
| G307.00 | Read | Acute subendocardial infarction | diagnostic | res72: MACE | MI | ||
| G307000 | Read | Acute non-Q wave infarction | diagnostic | res72: MACE | MI | ||
| G307100 | Read | Acute non-ST segment elevation myocardial infarction | diagnostic | res72: MACE | MI | ||
| G308.00 | Read | Inferior myocardial infarction NOS | diagnostic | res72: MACE | MI | ||
| G309.00 | Read | Acute Q-wave infarct | diagnostic | res72: MACE | MI | ||
| G30B.00 | Read | Acute posterolateral myocardial infarction | diagnostic | res72: MACE | MI | ||
| G30X.00 | Read | Acute transmural myocardial infarction of unspecif site | diagnostic | res72: MACE | MI | ||
| G30X000 | Read | Acute ST segment elevation myocardial infarction | diagnostic | res72: MACE | MI | ||
| G30y.00 | Read | Other acute myocardial infarction | diagnostic | res72: MACE | MI | ||
| G30y100 | Read | Acute papillary muscle infarction | diagnostic | res72: MACE | MI | ||
| G30y200 | Read | Acute septal infarction | diagnostic | res72: MACE | MI | ||
| G30yz00 | Read | Other acute myocardial infarction NOS | diagnostic | res72: MACE | MI | ||
| G30z.00 | Read | Acute myocardial infarction NOS | diagnostic | res72: MACE | MI | ||
| G311000 | Read | Myocardial infarction aborted | diagnostic | res72: MACE | MI | ||
| G311011 | Read | MI - myocardial infarction aborted | diagnostic | res72: MACE | MI | ||
| G35..00 | Read | Subsequent myocardial infarction | diagnostic | res72: MACE | MI | ||
| G350.00 | Read | Subsequent myocardial infarction of anterior wall | diagnostic | res72: MACE | MI | ||
| G351.00 | Read | Subsequent myocardial infarction of inferior wall | diagnostic | res72: MACE | MI | ||
| G353.00 | Read | Subsequent myocardial infarction of other sites | diagnostic | res72: MACE | MI | ||
| G35X.00 | Read | Subsequent myocardial infarction of unspecified site | diagnostic | res72: MACE | MI | ||
| G360.00 | Read | Haemopericardium/current comp folow acut myocard infarct | diagnostic | res72: MACE | MI | ||
| G362.00 | Read | Ventric septal defect/curr comp fol acut myocardal infarctn | diagnostic | res72: MACE | MI | ||
| G363.00 | Read | Ruptur cardiac wall w'out haemopericard/cur comp fol ac MI | diagnostic | res72: MACE | MI | ||
| G364.00 | Read | Ruptur chordae tendinae/curr comp fol acute myocard infarct | diagnostic | res72: MACE | MI | ||
| G365.00 | Read | Rupture papillary muscle/curr comp fol acute myocard infarct | diagnostic | res72: MACE | MI | ||
| G38..00 | Read | Postoperative myocardial infarction | diagnostic | res72: MACE | MI | ||
| G380.00 | Read | Postoperative transmural myocardial infarction anterior wall | diagnostic | res72: MACE | MI | ||
| G381.00 | Read | Postoperative transmural myocardial infarction inferior wall | diagnostic | res72: MACE | MI | ||
| G384.00 | Read | Postoperative subendocardial myocardial infarction | diagnostic | res72: MACE | MI | ||
| G38z.00 | Read | Postoperative myocardial infarction, unspecified | diagnostic | res72: MACE | MI | ||
| G575.12 | Read | Asystole | diagnostic | res72: MACE | MI | ||
| G60..00 | Read | Subarachnoid haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G600.00 | Read | Ruptured berry aneurysm | diagnostic | res72: MACE | Stroke | ||
| G601.00 | Read | Subarachnoid haemorrhage from carotid siphon and bifurcation | diagnostic | res72: MACE | Stroke | ||
| G602.00 | Read | Subarachnoid haemorrhage from middle cerebral artery | diagnostic | res72: MACE | Stroke | ||
| G603.00 | Read | Subarachnoid haemorrhage from anterior communicating artery | diagnostic | res72: MACE | Stroke | ||
| G604.00 | Read | Subarachnoid haemorrhage from posterior communicating artery | diagnostic | res72: MACE | Stroke | ||
| G605.00 | Read | Subarachnoid haemorrhage from basilar artery | diagnostic | res72: MACE | Stroke | ||
| G606.00 | Read | Subarachnoid haemorrhage from vertebral artery | diagnostic | res72: MACE | Stroke | ||
| G60X.00 | Read | Subarachnoid haemorrh from intracranial artery, unspecif | diagnostic | res72: MACE | Stroke | ||
| G60z.00 | Read | Subarachnoid haemorrhage NOS | diagnostic | res72: MACE | Stroke | ||
| G61..00 | Read | Intracerebral haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G610.00 | Read | Cortical haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G611.00 | Read | Internal capsule haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G61..11 | Read | CVA - cerebrovascular accid due to intracerebral haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G61..12 | Read | Stroke due to intracerebral haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G612.00 | Read | Basal nucleus haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G613.00 | Read | Cerebellar haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G614.00 | Read | Pontine haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G615.00 | Read | Bulbar haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G616.00 | Read | External capsule haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G617.00 | Read | Intracerebral haemorrhage, intraventricular | diagnostic | res72: MACE | Stroke | ||
| G618.00 | Read | Intracerebral haemorrhage, multiple localized | diagnostic | res72: MACE | Stroke | ||
| G61X.00 | Read | Intracerebral haemorrhage in hemisphere, unspecified | diagnostic | res72: MACE | Stroke | ||
| G61X000 | Read | Left sided intracerebral haemorrhage, unspecified | diagnostic | res72: MACE | Stroke | ||
| G61X100 | Read | Right sided intracerebral haemorrhage, unspecified | diagnostic | res72: MACE | Stroke | ||
| G61z.00 | Read | Intracerebral haemorrhage NOS | diagnostic | res72: MACE | Stroke | ||
| G62..00 | Read | Other and unspecified intracranial haemorrhage | diagnostic | res72: MACE | Stroke | ||
| G620.00 | Read | Extradural haemorrhage - nontraumatic | diagnostic | res72: MACE | Stroke | ||
| G621.00 | Read | Subdural haemorrhage - nontraumatic | diagnostic | res72: MACE | Stroke | ||
| G62z.00 | Read | Intracranial haemorrhage NOS | diagnostic | res72: MACE | Stroke | ||
| G63..00 | Read | Precerebral arterial occlusion | diagnostic | res72: MACE | Stroke | ||
| G63..11 | Read | Infarction - precerebral | diagnostic | res72: MACE | Stroke | ||
| G632.00 | Read | Vertebral artery occlusion | diagnostic | res72: MACE | Stroke | ||
| G63y000 | Read | Cerebral infarct due to thrombosis of precerebral arteries | diagnostic | res72: MACE | Stroke | ||
| G63y100 | Read | Cerebral infarction due to embolism of precerebral arteries | diagnostic | res72: MACE | Stroke | ||
| G640.00 | Read | Cerebral thrombosis | diagnostic | res72: MACE | Stroke | ||
| G640000 | Read | Cerebral infarction due to thrombosis of cerebral arteries | diagnostic | res72: MACE | Stroke | ||
| G641.00 | Read | Cerebral embolism | diagnostic | res72: MACE | Stroke | ||
| G641000 | Read | Cerebral infarction due to embolism of cerebral arteries | diagnostic | res72: MACE | Stroke | ||
| G641.11 | Read | Cerebral embolus | diagnostic | res72: MACE | Stroke | ||
| G64..12 | Read | Infarction - cerebral | diagnostic | res72: MACE | Stroke | ||
| G64..13 | Read | Stroke due to cerebral arterial occlusion | diagnostic | res72: MACE | Stroke | ||
| G64z.00 | Read | Cerebral infarction NOS | diagnostic | res72: MACE | Stroke | ||
| G64z000 | Read | Brainstem infarction | diagnostic | res72: MACE | Stroke | ||
| G64z.11 | Read | Brainstem infarction NOS | diagnostic | res72: MACE | Stroke | ||
| G64z111 | Read | Lateral medullary syndrome | diagnostic | res72: MACE | Stroke | ||
| G64z.12 | Read | Cerebellar infarction | diagnostic | res72: MACE | Stroke | ||
| G64z200 | Read | Left sided cerebral infarction | diagnostic | res72: MACE | Stroke | ||
| G64z300 | Read | Right sided cerebral infarction | diagnostic | res72: MACE | Stroke | ||
| G64z400 | Read | Infarction of basal ganglia | diagnostic | res72: MACE | Stroke | ||
| G66..00 | Read | Stroke and cerebrovascular accident unspecified | diagnostic | res72: MACE | Stroke | ||
| G661.00 | Read | Anterior cerebral artery syndrome | diagnostic | res72: MACE | Stroke | ||
| G66..11 | Read | CVA unspecified | diagnostic | res72: MACE | Stroke | ||
| G66..12 | Read | Stroke unspecified | diagnostic | res72: MACE | Stroke | ||
| G66..13 | Read | CVA - Cerebrovascular accident unspecified | diagnostic | res72: MACE | Stroke | ||
| G662.00 | Read | Posterior cerebral artery syndrome | diagnostic | res72: MACE | Stroke | ||
| G663.00 | Read | Brain stem stroke syndrome | diagnostic | res72: MACE | Stroke | ||
| G664.00 | Read | Cerebellar stroke syndrome | diagnostic | res72: MACE | Stroke | ||
| G665.00 | Read | Pure motor lacunar syndrome | diagnostic | res72: MACE | Stroke | ||
| G666.00 | Read | Pure sensory lacunar syndrome | diagnostic | res72: MACE | Stroke | ||
| G667.00 | Read | Left sided CVA | diagnostic | res72: MACE | Stroke | ||
| G668.00 | Read | Right sided CVA | diagnostic | res72: MACE | Stroke | ||
| G671.00 | Read | Generalised ischaemic cerebrovascular disease NOS | diagnostic | res72: MACE | Stroke | ||
| G671000 | Read | Acute cerebrovascular insufficiency NOS | diagnostic | res72: MACE | Stroke | ||
| G671z00 | Read | Generalised ischaemic cerebrovascular disease NOS | diagnostic | res72: MACE | Stroke | ||
| G676000 | Read | Cereb infarct due cerebral venous thrombosis, nonpyogenic | diagnostic | res72: MACE | Stroke | ||
| G6W..00 | Read | Cereb infarct due unsp occlus/stenos precerebr arteries | diagnostic | res72: MACE | Stroke | ||
| G6X..00 | Read | Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs | diagnostic | res72: MACE | Stroke | ||
| Gyu3400 | Read | [X]Acute transmural myocardial infarction of unspecif site | diagnostic | res72: MACE | MI | ||
| Gyu3600 | Read | [X]Subsequent myocardial infarction of unspecified site | diagnostic | res72: MACE | MI | ||
| Gyu6100 | Read | [X]Other subarachnoid haemorrhage | diagnostic | res72: MACE | Stroke | ||
| Gyu6200 | Read | [X]Other intracerebral haemorrhage | diagnostic | res72: MACE | Stroke | ||
| Gyu6300 | Read | [X]Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs | diagnostic | res72: MACE | Stroke | ||
| Gyu6400 | Read | [X]Other cerebral infarction | diagnostic | res72: MACE | Stroke | ||
| Gyu6F00 | Read | [X]Intracerebral haemorrhage in hemisphere, unspecified | diagnostic | res72: MACE | Stroke | ||
| Gyu6G00 | Read | [X]Cereb infarct due unsp occlus/stenos precerebr arteries | diagnostic | res72: MACE | Stroke | ||
| I20-I23 | ICD-10 | diagnostic | res72: MACE | MI | |||
| I60-164 | ICD-10 | diagnostic | res72: MACE | Stroke |
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