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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: Oral contraceptive
72 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 10201 | CPRD_product_code | Desogestrel 75microgram tablets | drug | res72: Oral contraceptive | |||
| 125 | CPRD_product_code | Dianette tablets (Bayer Plc) | drug | res72: Oral contraceptive | |||
| 12631 | CPRD_product_code | Ethinylestradiol with levonorgestrel and placebo 30micrograms + 150micrograms Tablet | drug | res72: Oral contraceptive | |||
| 1348 | CPRD_product_code | Noriday 350microgram tablets (Pfizer Ltd) | drug | res72: Oral contraceptive | |||
| 13810 | CPRD_product_code | Ethinylestradiol with levonorgestrel for post-coital contraception 50micrograms + 250micrograms Tabl | drug | res72: Oral contraceptive | |||
| 14459 | CPRD_product_code | Gynovlar 21 Tablet (Schering Health Care Ltd) | drug | res72: Oral contraceptive | |||
| 1466 | CPRD_product_code | Femulen 500microgram tablets (Pfizer Ltd) | drug | res72: Oral contraceptive | |||
| 14670 | CPRD_product_code | Ethinylestradiol with norethisterone - biphasic 7 x 35mcg+500mcg; 14 x 35mcg+1mg Tablet | drug | res72: Oral contraceptive | |||
| 14977 | CPRD_product_code | Ethinylestradiol with gestodene - triphasic 6 x 30+50mcg; 5 x 40+70mcg; 10 x 30+100mcg Tablet | drug | res72: Oral contraceptive | |||
| 15886 | CPRD_product_code | Ethinylestradiol with levonorgestrel - triphasic 6x30+50mcg; 5x40+75mcg; 10x30+125mcg Tablet | drug | res72: Oral contraceptive | |||
| 15987 | CPRD_product_code | Ethinylestradiol with norethisterone - triphasic 7 x 35+500mcg; 7 x 35+750mcg; 7 x 35mcg+1mg Tablet | drug | res72: Oral contraceptive | |||
| 1601 | CPRD_product_code | Trinovum tablets (Janssen-Cilag Ltd) | drug | res72: Oral contraceptive | |||
| 1613 | CPRD_product_code | Microval 30microgram tablets (Wyeth Pharmaceuticals) | drug | res72: Oral contraceptive | |||
| 1720 | CPRD_product_code | Levonorgestrel 30microgram tablets | drug | res72: Oral contraceptive | |||
| 18569 | CPRD_product_code | Gestodene with ethinylestradiol 75microgramwith20microgram Tablet | drug | res72: Oral contraceptive | |||
| 19131 | CPRD_product_code | Ethinylestradiol with gestodene and placebo 30micrograms + 75micrograms Tablet | drug | res72: Oral contraceptive | |||
| 19551 | CPRD_product_code | Controvlar Tablet (Schering Health Care Ltd) | drug | res72: Oral contraceptive | |||
| 2061 | CPRD_product_code | Norethisterone 350microgram tablets | drug | res72: Oral contraceptive | |||
| 2084 | CPRD_product_code | Ovran 30 Tablet (Wyeth Pharmaceuticals) | drug | res72: Oral contraceptive | |||
| 21343 | CPRD_product_code | Minovlar ed Tablet (Schering Health Care Ltd) | drug | res72: Oral contraceptive | |||
| 21733 | CPRD_product_code | Gestodene with ethinylestradiol 75microgramwith30microgram Tablet | drug | res72: Oral contraceptive | |||
| 22603 | CPRD_product_code | Clairette 2000/35 tablets (Stragen UK Ltd) | drug | res72: Oral contraceptive | |||
| 2265 | CPRD_product_code | Etynodiol 500microgram tablets | drug | res72: Oral contraceptive | |||
| 23211 | CPRD_product_code | Desogestrel with ethinylestradiol 150micrograms with 30micrograms tablets | drug | res72: Oral contraceptive | |||
| 23218 | CPRD_product_code | Ethinylestradiol with cyproterone acetate 35microgram with 2mg tablets | drug | res72: Oral contraceptive | |||
| 23897 | CPRD_product_code | Ethinylestradiol with levonorgestrel - triphasic with placebo 6x30+50mcg; 5x40+75mcg; 10x30+125mcg T | drug | res72: Oral contraceptive | |||
| 239 | CPRD_product_code | Micronor 350microgram tablets (Janssen-Cilag Ltd) | drug | res72: Oral contraceptive | |||
| 25124 | CPRD_product_code | Acnocin 2000microgram/35microgram tablets (Sandoz Ltd) | drug | res72: Oral contraceptive | |||
| 25263 | CPRD_product_code | Norgestimate with ethinylestradiol 250micrograms + 35micrograms Tablet | drug | res72: Oral contraceptive | |||
| 2553 | CPRD_product_code | Norgeston 30microgram tablets (Bayer Plc) | drug | res72: Oral contraceptive | |||
| 2769 | CPRD_product_code | Cyproterone acetate with ethinylestradiol 2mg with 35micrograms tablets | drug | res72: Oral contraceptive | |||
| 31528 | CPRD_product_code | Ethinylestradiol with norethisterone - triphasic 7x35+500mcg; 9x35mcg+1mg; 5x35+500mcg Tablet | drug | res72: Oral contraceptive | |||
| 31902 | CPRD_product_code | Cicafem 2000/35 tablets (Galen Ltd) | drug | res72: Oral contraceptive | |||
| 33098 | CPRD_product_code | Diva 2000/35 tablets (Zeroderma Ltd) | drug | res72: Oral contraceptive | |||
| 3436 | CPRD_product_code | Ortho-novin 1/50 Tablet (Janssen-Cilag Ltd) | drug | res72: Oral contraceptive | |||
| 3472 | CPRD_product_code | Trinovum ed ED tablets (Janssen-Cilag Ltd) | drug | res72: Oral contraceptive | |||
| 3538 | CPRD_product_code | Neocon 1/35 Tablet (Cilag Pharmaceuticals Ltd) | drug | res72: Oral contraceptive | |||
| 38500 | CPRD_product_code | Co-cyprindiol 2000microgram/35microgram tablets (Fannin UK Ltd) | drug | res72: Oral contraceptive | |||
| 40305 | CPRD_product_code | Qlaira tablets (Bayer Plc) | drug | res72: Oral contraceptive | |||
| 40618 | CPRD_product_code | Estradiol valerate and (estradiol valerate with dienogest) tablets | drug | res72: Oral contraceptive | |||
| 40650 | CPRD_product_code | Ethinylestradiol with norethisterone 35micrograms + 750micrograms Tablet | drug | res72: Oral contraceptive | |||
| 42510 | CPRD_product_code | Ethinylestradiol with levonorgestrel Tablet | drug | res72: Oral contraceptive | |||
| 43009 | CPRD_product_code | Minovlar 21 Tablet (Schering Health Care Ltd) | drug | res72: Oral contraceptive | |||
| 443 | CPRD_product_code | Desogestrel with ethinylestradiol 150micrograms with 20micrograms tablets | drug | res72: Oral contraceptive | |||
| 45059 | CPRD_product_code | Ethinylestradiol with levonorgestrel 30micrograms + 50micrograms Tablet | drug | res72: Oral contraceptive | |||
| 4608 | CPRD_product_code | Dianette tablets (Mylan) | drug | res72: Oral contraceptive | |||
| 47057 | CPRD_product_code | Yasminelle 3mg+20microgram Tablet (Bayer Plc) | drug | res72: Oral contraceptive | |||
| 47132 | CPRD_product_code | Co-cyprindiol 2mg+35microgram Tablet (Sandoz Ltd) | drug | res72: Oral contraceptive | |||
| 48570 | CPRD_product_code | Cerazette 75microgram tablets (Mawdsley-Brooks & Company Ltd) | drug | res72: Oral contraceptive | |||
| 53201 | CPRD_product_code | Dianette tablets (Lexon (UK) Ltd) | drug | res72: Oral contraceptive | |||
| 54527 | CPRD_product_code | Cerelle 75microgram tablets (Consilient Health Ltd) | drug | res72: Oral contraceptive | |||
| 54800 | CPRD_product_code | Desorex 75microgram tablets (Somex Pharma) | drug | res72: Oral contraceptive | |||
| 55819 | CPRD_product_code | Nacrez 75microgram tablets (Teva UK Ltd) | drug | res72: Oral contraceptive | |||
| 56103 | CPRD_product_code | Cerelle 75microgram tablets (Consilient Health Ltd) | drug | res72: Oral contraceptive | |||
| 56553 | CPRD_product_code | Generic Trinovum tablets | drug | res72: Oral contraceptive | |||
| 56732 | CPRD_product_code | Aizea 75microgram tablets (Besins Healthcare (UK) Ltd) | drug | res72: Oral contraceptive | |||
| 57748 | CPRD_product_code | Desomono 75microgram tablets (MedRx Licences Ltd) | drug | res72: Oral contraceptive | |||
| 58485 | CPRD_product_code | Zelleta 75microgram tablets (Morningside Healthcare Ltd) | drug | res72: Oral contraceptive | |||
| 59149 | CPRD_product_code | Generic Qlaira tablets | drug | res72: Oral contraceptive | |||
| 59414 | CPRD_product_code | Desogestrel 75microgram tablets (Actavis UK Ltd) | drug | res72: Oral contraceptive | |||
| 5986 | CPRD_product_code | Cerazette 75microgram tablets (Merck Sharp & Dohme Ltd) | drug | res72: Oral contraceptive | |||
| 61190 | CPRD_product_code | Co-cyprindiol 2000microgram/35microgram tablets (A A H Pharmaceuticals Ltd) | drug | res72: Oral contraceptive | |||
| 61465 | CPRD_product_code | Feanolla 75microgram tablets (Lupin Healthcare (UK) Ltd) | drug | res72: Oral contraceptive | |||
| 61890 | CPRD_product_code | Desogestrel 75microgram tablets (A A H Pharmaceuticals Ltd) | drug | res72: Oral contraceptive | |||
| 6431 | CPRD_product_code | Co-cyprindiol 2000microgram/35microgram tablets | drug | res72: Oral contraceptive | |||
| 6596 | CPRD_product_code | Norelgestromin with ethinylestradiol 203micrograms + 33.9micrograms/24hours Transdermal patch | drug | res72: Oral contraceptive | |||
| 67248 | CPRD_product_code | Dianette tablets (Waymade Healthcare Plc) | drug | res72: Oral contraceptive | |||
| 67274 | CPRD_product_code | Dianette tablets (Sigma Pharmaceuticals Plc) | drug | res72: Oral contraceptive | |||
| 68515 | CPRD_product_code | Teragezza 2000microgram/35microgram tablets (Morningside Healthcare Ltd) | drug | res72: Oral contraceptive | |||
| 8103 | CPRD_product_code | Conova 30 Tablet (Pharmacia Ltd) | drug | res72: Oral contraceptive | |||
| 9119 | CPRD_product_code | Minilyn Tablet (Organon Laboratories Ltd) | drug | res72: Oral contraceptive | |||
| 976 | CPRD_product_code | Schering PC4 Tablet (Schering Health Care Ltd) | drug | res72: Oral contraceptive |
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