Women with type 2 diabetes are nearly twice as likely as men to develop hidden heart damage.
A significant new study from University of Leicester researchers has found that women with type 2 diabetes are nearly twice as likely as men to experience hidden heart damage. The work was supported by a National Institute for Health and Care Research (NIHR) Professorship.
Published in the Journal of Cardiovascular Magnetic Resonance, the study is among the most comprehensive to date examining coronary microvascular dysfunction (CMD). It focused specifically on identifying how this early-stage heart damage may affect men and women differently, even when there are no outward signs of heart disease.
CMD refers to subtle, often undetected damage that results from reduced blood flow in the heart’s smallest vessels. By analyzing MRI scan data from four separate studies at the NIHR Leicester Biomedical Research Centre (BRC), scientists discovered signs of CMD in 46% of women with type 2 diabetes, while only 26% of men showed similar evidence.
“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, 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.”
Different Risk Drivers for Men and Women
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, Lifestyle, and Diabetes research teams to uncover complex 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. It’s 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 the 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.”
Reference: “Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes” by Jian L. Yeo, Abhishek Dattani, Joanna M. Bilak, Alice L. Wood, Lavanya Athithan, Aparna Deshpande, Anvesha Singh, J.Ranjit Arnold, Emer M. Brady, David Adlam, John D. Biglands, Peter Kellman, Hui Xue, Thomas Yates, Melanie J. Davies, Gaurav S. Gulsin and Gerry P. McCann, 6 December 2024, Journal of Cardiovascular Magnetic Resonance.
DOI: 10.1016/j.jocmr.2024.101132
Funding: NIHR Leicester Clinical Research Facility
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