Diabetes raises the risk of coronary heart disease in younger women

Article written by Bruce Sylvester

Women under 55 with type-2 diabetes have a 10-fold increased risk of developing coronary heart disease (CHD) during the two decades following diagnosis, researchers reported on Jan. 20, 2021 in JAMA Cardiology.

“We’re going to see, unfortunately, younger and younger people having heart attacks,” said investigator Samia Mora, MD, MHS, of the Brigham and Women’s Hospital Center for Lipid Metabolomics in the Division of Preventive Medicine and associate professor at Harvard Medical School, both in Boston.

“Prevention is better than cure, and many risk factors for heart disease are preventable. This study shows the impact that lifestyle has on heart health in women of all ages, and younger women in particular,” said investigator Sagar Dugani, MD, PhD, a hospital internal medicine practitioner at Mayo Clinic in Rochester, MN.

The investigators evaluated data from a prospective cohort of female health professionals participating in the (USA) Women’s Health Study. Median follow-up was 21.4 years. The cohort included 28, 024 subjects aged 45 years or older at enrollment and without known cardiovascular disease. The investigators obtained baseline data taken from April 30, 1993, to January 24, 1996, and conducted follow-up analyses from October 1, 2017, to October 1, 2020.

The researchers studied four age groups (<55, 55 to <65, 65 to <75, and ≥75 years) for CHD onset.

As they aged, the subjects contributed to different age-group data sets.

A diagnosis of diabetes correlated to the highest increased risk for CHD onset at any age, ranging from an 11-fold risk of CHD onset in subjects younger than 55 years to a 3.5-fold risk of CHD onset in those 75 years or older.

Other factors related to an increased risk in CHD onset among subjects younger than 55 years included metabolic syndrome (6-fold), hypertension (4.5-fold), obesity (4.3-fold) and smoking (4-fold).

“The study findings underscore the importance of diabetes and insulin resistance as major determinants of premature CHD, as well as other modifiable major risk factors that can be addressed with lifestyle or preventive interventions,” the authors said.