Sex Disparities in the Treatment and Control of Cardiovascular Risk Factors in Type 2 Diabetes
- Ioanna Gouni-Berthold, MD1,
- Heiner K. Berthold, MD, PHD2,
- Christos S. Mantzoros, MD3,
- Michael Böhm, MD4 and
- Wilhelm Krone, MD1
- 1Department of Internal Medicine II, University of Cologne, Cologne, Germany
- 2University of Bonn, Department of Clinical Pharmacology, Bonn, Germany
- 3Department of Medicine, Harvard Medical School, Boston, Massachusetts
- 4Department of Internal Medicine III, University of Homburg/Saar, Homburg/Saar, Germany
- Corresponding author: Ioanna Gouni-Berthold, ioanna.berthold{at}uni-koeln.de
Abstract
OBJECTIVE—To assess whether sex differences exist in the effective control and medication treatment intensity of cardiovascular disease (CVD) risk factors.
RESEARCH DESIGN AND METHODS—We performed a cross-sectional analysis including 44,893 patients with type 2 diabetes (51% women). End points included uncontrolled CVD risk factors (LDL cholesterol ≥130 mg/dl, systolic blood pressure [SBP] ≥140 mmHg, and A1C ≥8%) and the intensity of medical management in patients with uncontrolled CVD risk factors. Multiple-adjusted odds ratios were calculated after stratification for the presence of CVD (present in 39% of the patients).
RESULTS—Women with CVD were less likely to have SBP, LDL cholesterol, and A1C controlled and less likely to receive intensive lipid-lowering treatment. Women without CVD were less likely than men to have LDL cholesterol controlled with no differences in SBP or A1C control.
CONCLUSIONS—Women with diabetes and CVD have poorer control of important modifiable risk factors than men and receive less intensified lipid-lowering treatment.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 28 March 2008.
I.G.-B. and H.K.B. contributed equally to this work.
I.G.-B. has received honoraria for speaking engagements from Pfizer and Eli Lilly. M.B. has received speakers' honoraria from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, MSD Sharp & Dohme, Essex Pharma, Pfizer, Servier, and sanofi-aventis and has been on advisory panels for AstraZeneca, Boehringer Ingelheim, MSD Sharp & Dohme, Essex Pharma, Pfizer, Servier, and sanofi-aventis. W.K. has received grant/research support from MSD Sharp & Dohme and speakers' honoraria from AstraZeneca, MSD Sharp & Dohme, Essex Pharma, Pfizer, and sanofi-aventis and has been on advisory panels for MSD Sharp & Dohme and Essex Pharma.
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- Accepted March 25, 2008.
- Received January 29, 2008.
- DIABETES CARE
