Women with type 2 diabetes are nearly twice as likely as men to have hidden heart damage, according to a major new study by Leicester researchers funded through a National Institute for Health and Care Research (NIHR) Research Professorship.
The research, published in the Journal of Cardiovascular Magnetic Resonance, is one of the most detailed investigations into coronary microvascular dysfunction (CMD) to uncover sex-specific risk patterns in people with no signs of heart disease.
CMD is a form of early, silent heart damage caused by impaired blood flow in the heart’s smallest vessels. Using advanced MRI scans and data taken from four studies conducted at the NIHR Leicester Biomedical Research Centre (BRC), researchers found that 46% of the women with type 2 diabetes had signs of CMD, compared to just 26% of the men.
“We’re seeing early warning signs of heart disease that aren’t picked up through routine checks, and it’s women who seem to be most affected,” said NIHR Research Professor at the University of Leicester, Gerry McCann, the lead investigator of the study.
“What makes this study remarkable is that all participants were asymptomatic, which means they had no diagnosed heart problems, no chest pain, and no shortness of breath. Yet the scans told a different story.”
Dr Gaurav Gulsin, co-author and NIHR Clinical Lecturer added, “The study also found that the drivers of CMD differ by sex. In women, CMD was most strongly linked to higher body weight (BMI). However, in men, higher blood pressure was the more significant factor.
“This suggests we may need to rethink how we assess cardiovascular risk and that women and men could warrant sex-specific treatments.”
This paper also marks a milestone for the NIHR Leicester BRC showcasing the power of cross-theme collaboration of the Cardiovascular and Lifestyle research teams to uncover complex, layered insights that would not be possible in isolation.
“This is a fantastic example of what happens when teams across specialisms come together with a shared goal to spot disease earlier and improve outcomes for patients, this is exactly what the BRC was set up to do,” said Professor of Diabetes Medicine, Melanie Davies CBE, Director of the NIHR Leicester BRC and a co-author of this publication.
“The findings have significant implications for future prevention strategies. Interventions like weight loss for women and blood pressure control for men could help reduce early heart damage long before it progresses into heart failure which is a condition especially common in people with type 2 diabetes.”
Researchers now hope to test these targeted interventions in future clinical trials.
For the full paper please visit: https://pubmed.ncbi.nlm.nih.gov/39647765/