Impact of gender on relative rates of cardiovascular events in patients with diabetes

Angoulvant, Denis; Ducluzeau, Pierre Henri; Renoult-Pierre, Peggy; Fauchier, Grégoire; Herbert, Julien; Semaan, Carl; Bodin, Alexandre; Bisson, Arnaud; Fauchier, Laurent

doi:10.1016/j.diabet.2021.101226

Cited by 14 publications

(10 citation statements)

References 30 publications

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“…The reliability of PMSI data has already been assessed and this database has previously been used to study patients with CV conditions. [9][10][11][12][13][14] Use of medication was identified from a 1/97 permanent random sample of the complete French nationwide claims database (Echantillon Généraliste de Bénéficiaires [general sample of healthcare beneficiaries]). This is another database, not linked to the PMSI database, and it has been used previously to study patients with diabetes in France.…”

Section: Methodsmentioning

confidence: 99%

“…Patients had a period of 3 years (2010‐2012) to determine medical history. The reliability of PMSI data has already been assessed and this database has previously been used to study patients with CV conditions 9‐14 . Use of medication was identified from a 1/97 permanent random sample of the complete French nationwide claims database (Echantillon Généraliste de Bénéficiaires [general sample of healthcare beneficiaries]).…”

Section: Methodsmentioning

confidence: 99%

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Metabolically healthy obesity and cardiovascular events: A nationwide cohort study

Fauchier

Bisson

Bodin

et al. 2021

Diabetes Obesity Metabolism

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Aim: To evaluate the associations between metabolically healthy obesity (MHO) and different types of incident cardiovascular events in a contemporary population.Materials and Methods: All patients discharged from French hospitals in 2013 with at least 5 years of follow-up and without a history of major adverse cardiovascular event (MACE; myocardial infarction, heart failure [HF], ischaemic stroke or cardiovascular death [MACE-HF]) or underweight/malnutrition were identified. They were categorized by phenotypes defined by obesity and three metabolic abnormalities (diabetes, hypertension and hyperlipidaemia). Hazard ratios (HRs) for cardiovascular events during follow-up were adjusted on age, sex and smoking status at baseline. Results: In total, 2 873 039 individuals were included in the analysis, among whom 272 838 (9.5%) had obesity. During a mean follow-up of 4.9 years, when pooling men and women, individuals with MHO had a higher risk of MACE-HF (multivariate-

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Metabolically healthy obesity and cardiovascular events: A nationwide cohort study

Fauchier

Bisson

Bodin

et al. 2021

Diabetes Obesity Metabolism

Self Cite

View full text Add to dashboard Cite

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“… 11 , 12 Two other large population-based cohort studies also presented absolute CVD risk in diabetic and non-diabetic individuals. 21 , 22 However, these studies mainly focused on sex differences in relative CVD risk without adequately quantifying sex differences in increase of absolute CVD risk. We calculated the increase in absolute risk from their data and report that excess risk with type-2 diabetes was greater in men than in women in the Danish resident registry [WMD: −1.95 (−2.60 to −1.30)] as well as in the French hospitalization cohort that pooled type-1 and type-2 diabetes together [WMD: −13.00 (−13.96 to −12.04)].…”

Section: Discussionmentioning

confidence: 99%

“…We calculated the increase in absolute risk from their data and report that excess risk with type-2 diabetes was greater in men than in women in the Danish resident registry [WMD: −1.95 (−2.60 to −1.30)] as well as in the French hospitalization cohort that pooled type-1 and type-2 diabetes together [WMD: −13.00 (−13.96 to −12.04)]. 21 , 22 Taken together, these data indicate that reducing type-2 diabetes on a population level would prevent CVD events in both sexes, with a potential greater prevention in men than in women.…”

Section: Discussionmentioning

confidence: 99%

“…Although we focused on sex differences based on the increase of absolute risk, we would like to address that sex-related differences in associations of comorbidities with incident CVD are often reported based on relative risk differences; and suggestions to intensify preventive strategies in women vs. men are also frequently based on this measure. 7–9 , 22 If a similar approach would be followed for our study using only relative risk estimates to investigate sex differences in CVD, one would conclude that obesity was similarly associated with CVD in both sexes, but type-2 diabetes, hypertension, and AF were more strongly associated with CVD risk in women compared to men. Based on this line of reasoning, one would also advocate to reduce comorbidities predominantly in women.…”

Section: Discussionmentioning

confidence: 99%

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Sex differences in associations of comorbidities with incident cardiovascular disease: focus on absolute risk

Dronkers

Meems

Veldhuisen

et al. 2022

European Heart Journal Open

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Aim To examine sex differences in associations of obesity, type-2 diabetes, hypertension and atrial fibrillation (AF) with incident cardiovascular disease (CVD), focusing on absolute risk measures. Methods and results We included a total of 7994 individuals (mean age 49.1 years; 51.2% women) without prior CVD from the PREVEND (Prevention of Renal and Vascular End-stage Disease) cohort with a median follow-up of 12.5 years. Using Poisson regression, we calculated the increase in absolute as well as relative CVD risk associated with a comorbidity using incidence rate differences (IRD = IRcomorbidity−IRno-comorbidity) and incidence rate ratios (IRR = IRcomorbidity/IRno-comorbidity) respectively. Sex differences were presented as women-to-men differences (WMD = IRDwomen−IRDmen) and women-to-men ratios (WMR = IRRwomen/IRRmen). Absolute CVD risk was lower in women than in men (IRwomen: 6.73 versus IRmen: 14.58 per 1000 person-years). While increase in absolute CVD risk associated with prevalent hypertension was lower in women than in men (WMD: −6.12, 95% confidence interval: [−9.84 to −2.40], P = 0.001), increase in absolute CVD risk associated with prevalent obesity (WMD: −4.25 [−9.11 to 0.61], P = 0.087), type-2 diabetes (WMD: −1.04 [−14.36 to 12.29], P = 0.879) and AF (WMD: 18.39 [−39.65 to 76.43], P = 0.535) did not significantly differ between the sexes. Using relative risk measures, prevalent hypertension (WMR: 1.49, 95% confidence interval: [1.12 to 1.99], P = 0.006), type-2 diabetes (WMR: 1.73 [1.09 to 2.73], P = 0.019), and AF (WMR: 2.53 [1.12 to 5.70], P = 0.025) were all associated with higher CVD risk in women than in men. Conclusion Increase in absolute risk of developing CVD is higher in hypertensive men than hypertensive women, but no substantial sex-related differences were observed among individuals with obesity, type-2 diabetes and AF. On a relative risk scale, comorbidities, in general, confer a higher CVD risk in women than in men.

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The Diabetes-Cardiovascular Connection in Women: Understanding the Known Risks, Outcomes, and Implications for Care

et al. 2022

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Impact of gender on relative rates of cardiovascular events in patients with diabetes

Cited by 14 publications

References 30 publications

Metabolically healthy obesity and cardiovascular events: A nationwide cohort study

Metabolically healthy obesity and cardiovascular events: A nationwide cohort study

Sex differences in associations of comorbidities with incident cardiovascular disease: focus on absolute risk

The Diabetes-Cardiovascular Connection in Women: Understanding the Known Risks, Outcomes, and Implications for Care

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