title: Gender differences in composite control of cardiovascular risk factors among patients with type 2 diabetes.
abstract: OBJECTIVE
  Disparities in outcomes for cardiovascular disease (CVD) exist between men and women with type 2 diabetes mellitus (T2DM). We examined gender differences in composite control of cardiovascular risk factors in a sample of adults with T2DM.
  
  
  METHODS
  This was a cross-sectional study of 680 people recruited from three primary care settings. Primary outcomes were individual and composite control of CVD risk factors. Control of individual risk outcomes was defined as glycosylated hemoglobin A1c (HbA1c) level of <7%, blood pressure (BP) of <130/80 mm Hg, and low-density lipoprotein (LDL) cholesterol level of <100 mg/dL. Composite control was defined as having all three outcomes under control simultaneously. Linear and logistic regression models were used to assess differences in individual means and individual and composite outcomes control between men and women, while adjusting for relevant covariates.
  
  
  RESULTS
  Men made up 56% of the sample, approximately 67% were non-Hispanic black, and 78% made less than $35,000 annually. Unadjusted mean systolic BP (134 mm Hg vs. 130 mm Hg, P=0.005) and LDL cholesterol (99.7 mg/dL vs. 87.6 mg/dL, P<0.001) levels were significantly higher in women than in men. Adjusted linear regression showed mean diastolic BP (β=3.09; 95% confidence interval 0.56, 5.63) was significantly higher in women. Overall, 12.4% of the sample had composite control, and women had poorer composite control compared with men (5.9% vs. 17.3%). Adjusted logistic models showed that men were significantly more likely to have composite risk factor control (odds ratio 2.90; 95% confidence interval 1.37, 6.13) compared with women.
  
  
  CONCLUSIONS
  In this sample of adults with T2DM, women had significantly lower composite control compared with men, when adjusting for relevant confounders. It is imperative that women are informed about CVD risk factors, educated on how to reduce them, and aggressively treated to avoid adverse outcomes. Additional research involving women is needed to explore and reduce disparities in CVD risk between men and women with T2DM.
authors.affiliation: 1 Center for Health Disparities Research, Department of Medicine, Medical University of South Carolina , Charleston, South Carolina.
authors.forename: Joni L
authors.initials: JL
authors.lastname: Strom Williams
authors.forename: Cheryl P
authors.initials: CP
authors.lastname: Lynch
authors.forename: Rhonda
authors.initials: R
authors.lastname: Winchester
authors.forename: Leslie
authors.initials: L
authors.lastname: Thomas
authors.forename: Brad
authors.initials: B
authors.lastname: Keith
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011320:Primary Health Care; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
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