在2型糖尿病中心血管风险和风险因素管理:评估性别差异的基于人口的队列研究
Alison K Wright1,2, Evangelos Kontopantelis3, Richard Emsley4
1Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Manchester Academic Health Sciences Centre (A.K.W., D.M.A.).
Circulation
|April 16, 2019
概括
患有2型糖尿病 (T2DM) 的女性面临与男性相似的心血管风险增加,但在风险因素管理和药物处方方面存在差异,凸显了公平护理的需要.
科学领域:
- 心脏病学
- 内分泌学
- 公共卫生
背景情况:
- 英国糖尿病治疗临床实践的最新变化需要更新关于性别差异的数据.
- 需要对2型糖尿病 (T2DM) 的心血管风险和治疗进行当代估计.
研究的目的:
- 评估英格兰T2DM患者心血管风险和风险因素管理中的性别差异.
- 将T2DM男性和女性之间的心血管事件风险和药物处方模式进行比较.
主要方法:
- 使用与医院和死亡记录相关的临床实践研究数据链接进行回顾性队列研究.
- 确诊的79,985名T2DM患者 (2006-2013) 与没有糖尿病的386,547名对照患者相匹配.
- 用性别分层的Cox模型来评估心血管风险.
主要成果:
- 与没有T2DM的女性相比,患有T2DM的女性患心血管事件的风险更高 (aHR 1. 20);患有T2DM的男性患心血管事件的风险增加类似 (HR 1. 12).
- 在T2DM患者中,相对心血管风险增加不显著 (RR1. 07).
- 患有T2DM的女性更有可能肥胖,高血压和高胆固醇,但接受降脂药物和ACE抑制剂的可能性较低,特别是如果他们患有心血管疾病.
结论:
- 与T2DM男性相比,T2DM女性心血管风险的相对增加并不显著.
- 在T2DM风险因子管理的药物处方方面仍然存在显著的性别差异.
- 这些处方差异需要加强努力,以确保女性和男性都能得到公平高质量的糖尿病护理.
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