Original article| Volume 24, ISSUE 1, e61-e68, January 2014

Gender Differences in Cardiovascular Risk Factors in Incident Diabetes



      Cardiovascular disease is a major cause of morbidity and mortality for women and men with diabetes. Previous cross-sectional studies of prevalent diabetes have found that women are less likely to meet American Diabetes Association (ADA) and American Heart Association guidelines for control of cardiovascular risk factors (hemoglobin A1c, low-density lipoprotein [LDL] cholesterol, and blood pressure), but have not studied the critical period immediately after diagnosis.


      To assess gender differences in cardiovascular risk factors at the time of diabetes diagnosis (baseline) and 1 year later (follow-up), we conducted a retrospective cohort study of 6,547 individuals with incident diabetes in an integrated care delivery system. We assessed mean cardiovascular risk factor values by gender and adjusted odds ratios of attaining ADA goals.


      Compared with men, at baseline women had lower hemoglobin A1c (7.9% vs. 8.2%; p < .001), higher LDL cholesterol (118.9 vs. 111.5 mg/dL; p < .001), higher systolic blood pressure (131.9 vs. 130.5 mmHg; p < .001), and lower diastolic blood pressure (79.1 vs. 79.7 mmHg; p = .006). At follow-up, the hemoglobin A1c gender gap had closed (6.9% vs. 6.9%; p = .39), and the gender gaps had decreased for blood pressure (129.8/77.0 vs. 128.9/77.6; p = .009) and LDL cholesterol (104.0 vs. 98.2 mg/dL; p < .001). These associations varied by age. Adjusted odds ratios showed similar relationships.


      In this cohort of individuals with incident diabetes, men and women had important differences in risk factor control at the time of diabetes diagnosis. These differences varied by age and decreased over time.
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      Emily B. Schroeder, MD, PhD, is an epidemiologist and endocrinologist at Kaiser Permanente Colorado Institute for Health Research and an Assistant Professor in the Department of Medicine at the University of Colorado. Her research focuses on diabetes and its complications.


      Elizabeth A. Bayliss, MD, MSPH, is the Director for Scientific Development at the Kaiser Permanente Colorado Institute for Health Research and an Associate Professor in the Department of Family Medicine at the University of Colorado. Her research focuses on persons with multiple chronic medical conditions.


      Stacie L. Daugherty, MD, MSPH, is cardiologist and Assistant Professor of Medicine in the Department of Medicine at the University of Colorado. Her research focuses on gender differences in hypertension management and cardiovascular procedures.


      John F. Steiner, MD, MPH, is the Senior Director of the Kaiser Permanente Colorado Institute for Health Research and a Professor in the Department of Medicine at the University of Colorado. His research focuses on health disparities, prevention of cardiovascular disease, and medication adherence.