Heart Disease Deaths Not Dropping for Diabetic Women
as for Men; Less Treatment May Be Cause
Women have worse control of blood pressure, sugar and
cholesterol but given cholesterol-lowering medications less often
Another Possible Heart Disease Risk for Overweight Women: Low
Growth Hormone - Read below main story.
June 16, 2008 - Women with type 2 diabetes and
heart disease have poorer control of both diseases and receive less
intensive medical treatment than do men, which may help explain why
death due to heart disease has decreased among men but not women with
type 2 diabetes, according to a study presented yesterday.
The findings of the large new study found were
presented at The Endocrine Society’s 90th Annual Meeting in San
Francisco by primary author and study leader. Ioanna Gouni-Berthold, MD,
professor of medicine at the University of Cologne. The study was
performed at three German universities
“Our study shows that in patients with diabetes
there is a clear disparity between men and women in the control and
treatment of important modifiable risk factors for cardiovascular
disease,” Gouni-Berthold said.
“Women have worse control of their blood pressure,
blood sugar and cholesterol levels compared to men and are given
cholesterol-lowering medications less often.”
Gouni-Berthold and researchers from the University
of Bonn and University of Homburg studied nearly 45,000 people with type
2 diabetes treated as outpatients by private-practice physicians from
2002 to 2003. Of the patients, 9,521 men and 8,050 women had heart and
vascular disease.
There were no gender differences in the intensity
of medication management or most heart disease risk factors among
diabetic patients who did not have heart disease, the study found.
However, in the group with cardiovascular disease,
women were 44 percent more likely than men to have high LDL (“bad”)
cholesterol, yet 15 percent less likely to receive lipid-lowering
medications, the authors reported. Women also were 19 percent more
likely than men to have uncontrolled high blood pressure.
In addition, women were 15 percent more likely to
have poor long-term control of their blood glucose (sugar) level, as
shown by a hemoglobin A1c blood test above 8 percent. The recommended
A1c level for adults with type 2 diabetes is less than 7 percent.
The findings are cause for concern, according to
Gouni-Berthold, because there is evidence that diabetes cancels the
protective effect of female sex on the risk of heart disease.
“More aggressive treatment of cardiovascular
disease in women with diabetes may improve the gender disparity in
cardiovascular disease mortality,” she said. “Patients should speak with
their doctors about the intensity of treatment modalities.”
The study patients were part of the German DUTY
(Diabetes mellitus needs unrestricted evaluation of patient data to
yield treatment progress) Registry. Merck Sharp & Dohme provided a
research grant that funded the registry. However, the pharmaceutical
company had no influence on data analysis, according to Gouni-Berthold.
Another Possible Heart Disease Risk for Overweight Women:
Low Growth Hormone
June 16, 2008 - Low growth hormone
levels due to obesity may raise the risk of heart disease in
women who do not have pituitary disease, according to a new
study funded by the National Institutes of Health. The
preliminary results were another presentation yesterday at
The Endocrine Society’s 90th Annual Meeting in San
Francisco.
Doctors already know that abnormally
low levels of growth hormone, which the pituitary gland
naturally secretes in healthy people, can increase
cardiovascular risk in people whose pituitary glands are not
working properly. Growth hormone also can be low in people
who do not have pituitary problems but are overweight or
obese. Therefore, the authors wanted to find out if
overweight and obese women who do not have pituitary disease
are at increased risk of heart disease.
The authors found that some of the
overweight or obese women—but none of the thin women—had
growth hormone levels low enough to be classified as growth
hormone deficiency (below 5 ng/mL) if they had had pituitary
disease. Furthermore, the levels of some risk markers for
future heart disease, including high-sensitivity C-reactive
protein and HDL (“good”) cholesterol, were generally more
abnormal in women with low stimulated growth hormone levels
than in the other group.
“Our results raise the possibility
that low growth hormone levels in otherwise healthy
overweight and obese women may be associated with an
increased risk of heart disease,” said co-investigator Karen
Miller, MD, an endocrinologist at Massachusetts General
Hospital..
“However, it is premature to
recommend screening for low growth hormone levels in
clinical settings,” she said. “We don’t know whether growth
hormone therapy in these women would be beneficial or
harmful.”
Also, the U.S. Food and Drug
Administration has not approved growth hormone therapy for
use in people without pituitary disease, she added.
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