Cited by 279Cardiovascular Function and Risk FactorsHeart Failure Treatment and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

Diabetes as a risk factor for heart failure in women and men: a systematic review and meta-analysis of 47 cohorts including 12 million individuals

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Ohkuma, Toshiaki, Komorita, Yuji, Peters, Sanne A. E., Woodward, Mark·2019·Diabetologia

Abstract

AIMS/HYPOTHESIS: The prevalence of diabetes and heart failure is increasing, and diabetes has been associated with an increased risk of heart failure. However, whether diabetes confers the same excess risk of heart failure in women and men is unknown. The aim of this study was to conduct a comprehensive systematic review with meta-analysis of possible sex differences in the excess risk of heart failure consequent to diabetes. Our null hypothesis was that there is no such sex difference. METHODS: A systematic search was conducted in PubMed for population-based cohort studies published between January 1966 and November 2018. Studies were selected if they reported sex-specific estimates of RRs for heart failure associated with diabetes, and its associated variability, which were adjusted at least for age. Random-effects meta-analyses with inverse variance weighting were used to obtain pooled sex-specific RRs and women-to-men ratio of RRs (RRRs) for heart failure associated with diabetes. RESULTS: Data from 47 cohorts, involving 12,142,998 individuals and 253,260 heart failure events, were included. The pooled multiple-adjusted RR for heart failure associated with type 1 diabetes was 5.15 (95% CI 3.43, 7.74) in women and 3.47 (2.57, 4.69) in men, leading to an RRR of 1.47 (1.44, 1.90). Corresponding pooled RRs for heart failure associated with type 2 diabetes were 1.95 (1.70, 2.22) in women and 1.74 (1.55, 1.95) in men, with a pooled RRR of 1.09 (1.05, 1.13). CONCLUSIONS/INTERPRETATION: The excess risk of heart failure associated with diabetes is significantly greater in women with diabetes than in men with diabetes. PROSPERO registration: CRD42019135246.

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  1. [12]Stroup DF Berlin JA Morton SC Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group JAMA 2000 283 15 2008 2012 10789670

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Authors
Ohkuma, T., Komorita, Y., Peters, S. A. E., & Woodward, M.
Affiliations
  • Royal Prince Alfred Hospital (AU)
  • Kyushu University (JP)
  • The George Institute for Global Health (GB)
  • Johns Hopkins University (US)
Corresponding author
  • Ohkuma, Toshiaki
  • Peters, Sanne A. E.
Venue
Diabetologia
Published
2019-07-18
Volume
62
Issue
9
Pages
1550-1560
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
OpenAlex
W2960917570
Cited by
279
References
49
Citations by year
2026: 25 · 2025: 30 · 2024: 49 · 2023: 47 · 2022: 43 · 2021: 46 · 2020: 38 · 2019: 1
FWCI
5.79
Type
journal article
Language
en
Open access
Locations
  • Diabetologia (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
Funders
University of Oxford
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
diabetes mellitus, heart failure, sex differences, type 1 diabetes, type 2 diabetes, women, men, relative risk, cardiovascular risk
MeSH terms
Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Heart Failure, Humans, Male, Risk Factors, Sex Factors

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