Why Women With Diabetes Are At Higher Risk Of Heart Disease

While deaths due to heart disease have notably declined among the elderly women population, studies demonstrate that death rates among younger women patients have remained quite stagnant or have shown a slight increase.

To comprehend which factors put younger women at a higher risk of coronary heart disease (CHD), researchers from the prestigious Brigham and Women’s Hospital in association with the Mayo Clinic analysed more than fifty risk factors in 28,024 women who actively participated in the several decades-long Women’s Health Study.

Markedly, women below the age of 55 with type 2 diabetes had as much as a tenfold higher risk of developing CHD over the subsequent two decades, with lipoprotein insulin resistance (LPIR) emerging as a robust and predictive biomarker, too. These findings are further published in JAMA Cardiology.

According to Samia Mora (corresponding author), MD, MHS, of the Brigham’s Centre for Lipid Metabolomics in the Preventive Medicine division as well as an associate professor at Harvard Medical School, there will be an increasing number of heart attacks among younger women. She goes on to state that when a younger woman has CHD, it will significantly affect the quality of their life going forward as well as their productivity and their eventual contribution to society.

According to Sagar Dugani, MD, PhD, a practitioner of internal medicine at Mayo Clinic in Rochester, MN, prevention is certainly better than cure, and numerous risk factors for women heart disease can be successfully prevented. Dr Sagar Dugani is the study’s co-first author.

The researchers successfully analysed nearly 50 biomarkers that are associated with cardiovascular health. Commonly used metrics such as LDL (low-density lipoprotein) cholesterol or bad cholesterol and haemoglobin A1C (which is a measure of blood sugar levels) had substantially weaker associations with the onset of CHD in women (below the age of 55) in comparison with LPIR, which is a newer metric when it comes to insulin resistance.

LPIR makes use of a weighted combination of 6 lipoprotein measures. Moreover, it is analysed only through specialised lab testing. While LDL cholesterol was merely associated with a 40% increase in the overall risk of the onset of CHD in women below the age of 55, LPIR demonstrated a sixfold or 600% increase.

Dr Mora went on to say that in otherwise healthy women, type 2 diabetes, insulin resistance, and its sister diagnosis (metabolic syndrome) were significant contributors to premature coronary events. She also said that women below the age of 55 who are obese had nearly a fourfold increase in risk for coronary events, which is similar to women in the same age group who were smokers or were diagnosed with hypertension. She concludes by saying that physical inactivity, as well as family history, are all “part of the picture as well.”

Researchers acknowledged that the study is quite limited when it comes to generalizability: beyond its focus on women (who have demonstrated worse outcomes post premature cardiac events in comparison with men), 95% of the participants of the study. According to Dr Mora, the research findings could be much more dramatic when it comes to racial and ethnic groups, who are known to have a higher prevalence of insulin resistance, diabetes, and metabolic syndrome, among other risk factors.

Dr Mora has also stated that even though diabetes is preventable, it is a system-wide concern, and there urgently needs to be further research in finding newer strategies to successfully address it. Elaborating further, Dr Mora says that when it comes to strategies there should be innovative, lifestyle-based strategies, such as greater public health efforts, community efforts, ways and means to target metabolic pathways medically, and new surgical approaches.

While the prevalence of diabetes and its several associated risk factors increasing exponentially and affecting more women in comparison with men, the researchers have stressed the urgent need of developing effective interventions.

To sum it all up, Dr Mora said that the need of the hour is the development of new strategies to help in improving outcomes in younger women and to address the risk posed by diabetes because this is merely the “beginning” of the diabetes epidemic.

On A Final Note

Researchers from Brigham and Women’s Hospital and Mayo Clinic carried out a study that involved 28,024 women, wherein more than 50 risk factors were analysed. The research findings indicate that women aged below 55 with a positive diagnosis for type 2 diabetes had a tenfold increased risk of developing CHD, with LPIR being a strong, predictive biomarker.

References: