Cardiovascular Journal of Africa: Vol 27 No 4 (July/August 2016)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 4, July/August 2016 AFRICA 257
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Gender differences in the control of multiple cardiovascular
disease risk factors in type 2 diabetes patients
Adjusted mean diastolic blood pressure levels were found to
be significantly higher in women compared to men, but other
risk factors were almost the same between genders, according
to recent research.
Williams and colleagues conducted a cross-sectional study
in which patients were randomly recruited from three primary
care clinics in the south-eastern USA and asked to complete a
self-report survey yielding data relevant to gender differences
in cardiovascular disease (CVD) risk-factor control. The
primary outcomes were individual diabetes-related risks,
which were defined as not having an HbA1c level < 7%, blood
pressure of < 130/80 mmHg, and low-density lipoprotein
(LDL) cholesterol level < 100 mg/dl (2.59 mmol/l), and
composite control defined as having all three outcomes under
control simultaneously.
Of the patients enrolled, 56% were men, 67% were
non-Hispanic black, and 78%made less than $35 000 per year.
Unadjusted mean systolic blood pressure (134 vs 13 mmHg, p
= 0.005) and LDL cholesterol levels [99.7 vs 87.6 mg/dl (2.58
vs 2.27 mmol/l), p < 0.001] were much higher in women than
in men; however, after adjusting for relevant confounders,
differences in systolic blood pressure and LDL cholesterol
levels were not significant. Adjusted mean diastolic blood
pressure levels were found to be significantly higher in women
compared to men (β = 3.09, 95% CI = 0.56–5.63).
Regarding the gender differences in composite control, the
results showed that women had poorer control of multiple
CVD risk outcomes than men (β = 2.90, 95% CI = 1.37–6.13).
Other primary outcomes were not statistically significantly
different, including glycaemic control in both genders.
Limitations of this study included the fact that the cross-
sectional study design did not prove causal associations.
Also, confounders not controlled for included diabetes
knowledge, self-management practices, medication adherence,
co-morbidity burden, social support, duration of diabetes,
medications used to treat diabetes, and hypertension. In
addition, high triglyceride level was an independent risk
factor for coronary heart disease, particularly for women.
In conclusion, further study is needed. In the meantime,
both genders, but especially women, need to be encouraged to
adopt healthy lifestyle habits with a view to modifying their
risk factors and achieving better outcomes.
References
1. Williams J, Lunch C, Winchester R, et al . Gender differences in
composite control of cardiovascular risk factors among patients
with type 2 diabetes. Diabetes Technol Therapeut 2014; 16(7):
421–427.
2.
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