The researchers studied two classes of type 2 diabetes drugs and found that one class was associated with a greater reduction in major reversible cardiovascular events in men than in women.
Two classes of drugs are SGLT2 inhibitors (SGLT2 or SGLT2i), also called gliflozins, and glucagon-like peptide-1 receptor agonists (GLP-1RA). Both classes of drugs reduce serious adverse cardiovascular events in people with type 2 diabetes.
Although women with type 2 diabetes are at greater risk of cardiovascular disease and heart failure than men with the same type of diabetes, treatment for cardiovascular disease caused by diabetes remains the same for both sexes.
Thus, the Monash Institute of Pharmaceutical Sciences (MIPS) team set out to directly compare and characterize the sex-specific effects of SGLT2i with GLP-1RA on major adverse cardiovascular events in men and women, with further subgroup analysis based on age. and history Congestive heart.
The study, published in The Lancet Regional Health, involved 8,026 Australian men and women with type 2 diabetes (mean age 30 years) who were discharged from Victoria Hospital between July 1, 2013 and July 1, 2017 and used SGLT2i or GLP-1RA. against the background of treatment 60 days after discharge from the hospital.
With a mean follow-up of 756 days, SGLT2i exposure reduced the risk of serious adverse cardiovascular events such as heart failure and stroke to a greater extent in men of all ages with type 2 diabetes than in women of the same age. group.
Overall, there was a 22% reduction in major adverse cardiovascular events in men using SGLT2i compared to men using GLP-1RA, while in women there was no significant difference between SGLT2i and GLP-1RA in terms of impact on serious adverse cardiovascular events.
The group also showed for the first time that SGLT2i, compared with GLP-1RA, reduced the incidence of major CVD in both older men and women (65 years) with type 2 diabetes, men with a history of heart failure, and women with primary atherosclerotic disease of the heart and blood vessels.
The study’s first author, Dr. Apipre Sharma, said the apparent discrepancy between the relative benefits of SGLT2i versus GLP-1RA in men and women with type 2 diabetes warrants further study.
She added: “Recommendations for the treatment of cardiovascular disease associated with type 2 diabetes and heart failure remain the same for men and women, despite known gender differences in the progression and symptoms of these diseases. Our analysis shows that these new classes of antihyperglycemic drugs may in fact. Effects may be better expressed in relation to age and gender, which we believe warrants further study.”
Study co-author Professor Rebecca Ricci noted that there may be a number of reasons why women with type 2 diabetes are more likely to develop cardiovascular disease and heart failure than men with type 2 diabetes.
And she continued, “Women with type 2 diabetes typically have more insulin resistance, endothelial dysfunction, inflammation, abdominal obesity, body mass index, blood glucose and cholesterol levels than men with type 2 diabetes.” the risk of heart failure in postmenopausal women suggests an additional component.
“We hope that the results of this large population-based study will provide a deeper dive into recommendations for more effective drug therapy based on factors such as gender, age, and history of heart failure,” concluded Professor Ricci.
Source: Medical Express
