Troubled Hearts for Women with Diabetes

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Diabetes in women under 60 may quadruple the risk for heart disease

November 1, 2013 / Author:  / Reviewed by: Chris Galloway, M.D. Beth Bolt, RPh

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(dailyRx News) In general, women under the age of 60 are less likely than men to get heart disease. Having diabetes, however, can be a game changer, potentially raising a woman’s heart disease risk to that of a man.

Diabetes can be hard on the heart. Over time, high blood sugar levels can lead to increased deposits of fatty materials on the insides of the blood vessel walls, which is called atherosclerosis.

While diabetes has been a known heart risk, a new study found that its effects on the hearts of women under the age of 60 may be much greater than previously thought.

The study showed that diabetes substantially raised rates of coronary artery disease among women, and that women with diabetes had similar rates of coronary artery disease as those of men with diabetes.

"Exercise and eat healthily to help prevent heart disease."

Rita Rastogi Kalyani, MD, an endocrinologist and assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore, led this review which looked at three major studies of more than 11,000 men and women who were under the age of 60 and had coronary artery disease (CAD).

The researchers compared CAD in patients in terms of person-years. Person-years is the product of the number of years a population has been affected by a condition and the number of members of a population who have been affected by that condition.

While CAD rates were lower in women than men without diabetes, CAD event rates were similar among both men and women who had diabetes. The rates of CAD for women with diabetes were 17.65, 7.34 and 2.37 per 1,000 person-years for the three studies, respectively, compared with 12.86, 9.71 and 1.83 per 1,000 person-years for the men.

In evaluating just the women, the researchers found that those with diabetes had a four to five times higher CAD rate than those without the disease. Among men, however, diabetes had little or no impact on heart disease risk.

Dr. Kalyani told dailyRx News, “Men in this age group have a high risk of heart disease to begin with and the additional presence of diabetes does not seem to increase the risk of heart disease substantially further.”

As to why women experienced an increased likelihood of heart problems, Dr. Kalyani said that there may be some genetic or hormonal reasons that diabetes affects women differently. Also, men and women may not stick to heart healthy lifestyle behaviors and treatment at similar rates.

“Some other studies have suggested that therapies to prevent heart disease may not be prescribed as frequently in women with diabetes compared to men, but this requires further investigation,” she said.

Because women of any age with diabetes are at high risk of developing diabetes, Dr. Kalyani recommends that all women adopt a heart-healthy diet and lifestyle.

“In addition,” she told dailyRx News, “women with diabetes should continue to discuss with their healthcare providers ongoing strategies to reduce their risk of developing heart disease as part of their comprehensive treatment plan.”

"There is a very interesting connection between diabetes and heart disease. It's magnesium. One of the signs of diabetes is low magnesium blood levels. The heart has the highest concentration of magnesium in the body," Carolyn Dean, MD, Medical Advisory Board Member for the non-profit Nutritional Magnesium Association, told dailyRx News.

"Several recent studies show that women who take calcium supplements have a higher risk for heart disease. This is because without the balancing mineral 'magnesium', calcium throws magnesium out of the body," said Dr. Dean, who was not involved with this study.

"The solution? Take more magnesium to treat both these conditions and try to get your calcium from your diet, not from supplements. There is a growing amount of scientific evidence pointing to high calcium/low magnesium intake leading to calcification, or hardening, of arteries (atherosclerosis — the number one cause of death in the US), osteoporosis and osteoporotic bone fractures," said Dr. Dean.

"If we consume too much calcium without sufficient magnesium, not only will we create stress within the body but the excess calcium won’t be utilized correctly and may  become toxic. Magnesium keeps calcium dissolved in the blood. Too much calcium and too little magnesium can cause some forms of arthritis, kidney stones, osteoporosis and calcification of the arteries, leading to heart attack and cardiovascular disease," she said.

"Go for a 1:2 or at the very least a 1:1 calcium-magnesium balance and use an absorbable form of magnesium such as a magnesium citrate powder,” she recommended.

This study was published on October 31 in the journal Diabetes Care.