Abstract
Background: Among individuals with Type 2 diabetes (T2DM), cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Sex and gender differences (SGDs) in the cardiovascular consequences of T2DM are relevant suggesting the need for a more aggressive CVD preventive strategy in diabetic women as they lose the so-called "female advantage" in terms of CVD risk comparing with the nondiabetic population. Multiple factors may explain the disproportion in CVD risk among women with diabetes comparing with diabetic men or non-diabetic women. Both genetic and hormonal factors only partially explain SGDs in CVD risk in diabetes. However, women likely reach diagnosis later and in worse conditions, they undergo both diagnostic and therapeutic supports in lower percentage and, finally, they are not able to obtain therapeutic goals recommended by guidelines. Concerning the cardiovascular system, diabetes amplifies the extent of damage at both micro- and macrovascular level differently among sexes.
Methods: The aim of this review is to clarify, in a sex and gender perspective, the impact of diabetes in CVD risk and to summarize the most important SGDs in CVD primary and secondary prevention strategies such as antiplatelet drugs and statins. Results: The efficacy of ASA and/or statins in secondary prevention is documented in both sexes independently by the presence of T2DM. A different approach to CVD primary prevention with ASA using the age cut-off to discriminate sex differences has been recommended. The use of statins for primary prevention in women should be accurately monitored for the occurrence of myalgia and risk of developing diabetes. Conclusion: A gender approach in CVD prevention strategies is urgently required to achieve a sensible reduction of adverse CV events.Keywords: Diabetes, antiplatelet therapy, statins, sex, gender, cardiovascular disease, and prevention.
Current Pharmaceutical Design
Title:Sex Differences in Type-2 Diabetes: Implications for Cardiovascular Risk Management
Volume: 23 Issue: 10
Author(s): Valeria Raparelli, Susanna Morano, Flavia Franconi, Andrea Lenzi and Stefania Basili*
Affiliation:
- Department of Internal Medicine and Medical Specialties, Viale del Policlinico 155, 00144 Rome,Italy
Keywords: Diabetes, antiplatelet therapy, statins, sex, gender, cardiovascular disease, and prevention.
Abstract: Background: Among individuals with Type 2 diabetes (T2DM), cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Sex and gender differences (SGDs) in the cardiovascular consequences of T2DM are relevant suggesting the need for a more aggressive CVD preventive strategy in diabetic women as they lose the so-called "female advantage" in terms of CVD risk comparing with the nondiabetic population. Multiple factors may explain the disproportion in CVD risk among women with diabetes comparing with diabetic men or non-diabetic women. Both genetic and hormonal factors only partially explain SGDs in CVD risk in diabetes. However, women likely reach diagnosis later and in worse conditions, they undergo both diagnostic and therapeutic supports in lower percentage and, finally, they are not able to obtain therapeutic goals recommended by guidelines. Concerning the cardiovascular system, diabetes amplifies the extent of damage at both micro- and macrovascular level differently among sexes.
Methods: The aim of this review is to clarify, in a sex and gender perspective, the impact of diabetes in CVD risk and to summarize the most important SGDs in CVD primary and secondary prevention strategies such as antiplatelet drugs and statins. Results: The efficacy of ASA and/or statins in secondary prevention is documented in both sexes independently by the presence of T2DM. A different approach to CVD primary prevention with ASA using the age cut-off to discriminate sex differences has been recommended. The use of statins for primary prevention in women should be accurately monitored for the occurrence of myalgia and risk of developing diabetes. Conclusion: A gender approach in CVD prevention strategies is urgently required to achieve a sensible reduction of adverse CV events.Export Options
About this article
Cite this article as:
Raparelli Valeria, Morano Susanna, Franconi Flavia, Lenzi Andrea and Basili Stefania*, Sex Differences in Type-2 Diabetes: Implications for Cardiovascular Risk Management, Current Pharmaceutical Design 2017; 23 (10) . https://dx.doi.org/10.2174/1381612823666170130153704
DOI https://dx.doi.org/10.2174/1381612823666170130153704 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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