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[Is cardiovascular risk different in the diabetic woman?].

Cardiovascular disease is a leading cause of mortality among diabetic women. However, studies devoted to cardiovascular disease in women, and particularly diabetic women, are scarce. Diabetes erases the natural protection of premenopausal women against cardiovascular disease. Risk of death from coronary artery disease is higher in diabetic women than in diabetic men. Diabetic women might be more exposed to some risk factors. Non invasive diagnostic tools of coronary artery disease are less accurate in women, and women are less likely than men to undergo catheterization or revascularization. The lower diameter of coronary artery might contribute to these reluctances. Nevertheless, long-term outcome of the revascularization procedures (thrombolysis, bypass graft, angioplasty) are similar in men and women, although peri-procedural risks might be higher in women. Finally, secondary prevention treatments, particularly beta-blockers, are underused in women. Gender differences in cardiovascular risk among diabetics are partly explained by discrepancies in terms of coronary artery anatomy or lack of reliable non invasive tests. But the longer delay to treatment and the lack of scientific information about the particular features of coronary heart disease in women probably contribute to the increased risk in diabetic women.