Posted by admin in Prescription Diabetes Drugs on November 07th, 2009

Diabetes may attenuate gender differences in the risk for fatal cardiac events, a new analysis of the Atherosclerosis Risk in Communities (ARIC) study suggests.

This “risk-equalizing effect” is important because it suggests that women with diabetes “constitute a population group at a high risk of cardiac death,” say Anna Kucharska-Newton (University of North Carolina, Chapel Hill, USA) and co-authors writing in the journal Acta Diabetologia.

For their study, Kucharska-Newton and team examined the influence of Type 2 diabetes on the incidence of sudden cardiac death (SCD) and fatal and non-fatal coronary heart disease. Their analysis included 13,978 participants in the ARIC study, a prospective US population-based cohort of men and women aged 45??”64 years and free of vascular disease at baseline.

The researchers divided participants according to the presence or absence of diabetes at baseline. Diabetic individuals were older, more likely to be Black, and to have heart failure and hypertension than those without diabetes.

Between recruitment in 1987??”1989 and follow-up in 2001, there were 209 SCDs, 119 non-sudden cardiac deaths (primarily fatal myocardial infarctions [MIs]), and 739 non-fatal MIs. The risk for each of the three outcomes was greater in men compared with women, in Blacks compared with Whites, and in diabetics compared with non-diabetics.

In non-diabetic participants, the incidence of all three outcomes was lower among women than men. Intriguingly, however, the gender disparity in SCD was attenuated in the presence of diabetes, such that the incidence in women approximated the incidence in men.

The researchers say they failed to find evidence supporting their initial hypothesis of a specific association of diabetes with the risk of SCD; instead, traditional cardiovascular risk factors explained the increased risk in the overall cohort and in subgroup analyses.

Commenting on the increased risk for SCD in Black individuals, they write: “The results indicate that Blacks with diabetes are at especially high risk of cardiac mortality and represent a group that can benefit from efforts aimed at prevention of SCD.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

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