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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

Link to article
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

Code list: res72: Obesity

21 codes in list

Code Coding system Description Entity type List name
22A5.11 Read O/E - obese diagnostic res72: Obesity
22K5.00 Read Body mass index 30+ - obesity diagnostic res72: Obesity
22K7.00 Read Body mass index 40+ - severely obese diagnostic res72: Obesity
22KC.00 Read Obese class I (body mass index 30.0 - 34.9) diagnostic res72: Obesity
22KD.00 Read Obese class II (body mass index 35.0 - 39.9) diagnostic res72: Obesity
22KE.00 Read Obese class III (BMI equal to or greater than 40.0) diagnostic res72: Obesity
66C4.00 Read Has seen dietician - obesity diagnostic res72: Obesity
66C5.00 Read Treatment of obesity changed diagnostic res72: Obesity
66C6.00 Read Treatment of obesity started diagnostic res72: Obesity
8CV7.00 Read Anti-obesity drug therapy commenced diagnostic res72: Obesity
C38..00 Read Obesity and other hyperalimentation diagnostic res72: Obesity
C380.00 Read Obesity diagnostic res72: Obesity
C380200 Read Extreme obesity with alveolar hypoventilation diagnostic res72: Obesity
C380300 Read Morbid obesity diagnostic res72: Obesity
C380400 Read Central obesity diagnostic res72: Obesity
C380500 Read Generalised obesity diagnostic res72: Obesity
C38y011 Read Obesity hypoventilation syndrome diagnostic res72: Obesity
C38z000 Read Simple obesity NOS diagnostic res72: Obesity
Cyu7.00 Read [X]Obesity and other hyperalimentation diagnostic res72: Obesity
Cyu7000 Read [X]Other obesity diagnostic res72: Obesity
ZC2CM00 Read Dietary advice for obesity diagnostic res72: Obesity

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