Gender differences could mean more risk for cardiovascular death

June 24, 2014

Queen's University assistant professor Pendar Farahani (Department of Medicine and Department of Public Health Sciences) is advocating the use of gender-based treatment for mitigating the cardiovascular risk factors related to diabetes.

Research has shown women with Type 2 diabetes and high cholesterol are less likely than their male peers to reach treatment goals to lower their bad cholesterol, or low-density lipoprotein (LDL) cholesterol.

"The findings suggest the need for gender-based evaluation and treatment of cardiovascular risk factors in these patients," says Dr. Farahani. "We need further study into the gender disparities to tailor drug interventions and we need to increase the inclusion of women in clinical trials."

With treatment, only 64 per cent of women lowered their LDL cholesterol to the recommended level compared with 81 per cent of men, the investigators reported. Research has shown women have poorer adherence to taking their statin medication to treat high cholesterol, perhaps due to somewhat dissimilar pharmacological properties in a woman's body than a man's. For example, women often have more side effects such as muscle pain, explains Dr. Farahani.

"The finding that women were not able to lower their so-called bad cholesterol sufficiently is a concern," he says. "Women with diabetes have a considerably higher rate of cardiovascular-related illness and death than men with diabetes. This pattern is likely related to poorer control of cardiovascular risk factors."

Dr. Farahani's research also discovered access to medication is not responsible for this difference. All patients, who were in a database from pharmacies in four Canadian provinces, had social insurance and could afford their medications.

To evaluate whether biological sex influenced the results of cholesterol-lowering drug treatment, Dr. Farahani included nearly equal numbers of men and women (101 and 97) in the study. The average age of participants was 65 years for men and 63 years for women. All patients had Type 2 diabetes and had filled prescriptions for statin medication to treat high cholesterol between 2003 and 2004.
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The results were presented on Saturday at the joint meeting of the International Society of Endocrinology and The Endocrine Society: ICE/ENDO 2014 in Chicago.

Queen's University

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