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Is Diabetes Equivalent to Heart Disease in Women?

Posted Apr 09 2013 3:00am
If you look at the details behind the Framingham risk calculator  used to predict risk of a heart attack in the next decade, those w/known heart disease are specifically excluded as they are assumed to have a 20% or greater risk for recurrent event.  And in case you didn't already know, >20% is considered high risk while low risk is <10%.  Moderate risk is everything in between.

Of note, as I mentioned in my post last Friday , symptomatic carotid stenosis, abdominal aortic aneurysm, and peripheral artery/vascular disease are also considered coronary heart disease equivalents.  But since most of the study participants were male, does this calculator really apply to women?   Another analysis of the Raloxifene Use for the Heart (RUTH) was published last month in Circulation: Cardiovascular Quality Outcomes in which the authors concluded that diabetes in women is a heart disease equivalent just as it is in men.  

To arrive at their conclusion, the authors followed for over 5yrs 6,937 postmenopausal women avg 67+yo.  Those women with diabetes but w/o heart disease had a similar rate of death due to cardiac events as those women w/heart disease but w/o diabetes.  So even as we attempt to personalize medicine these days, we can also apply this generalization to women as well as to men.  Bottom line: regardless of medical condition, eg diabetes vs heart disease, we need to aggressively treat all risk factors.

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