Women with diabetes have poorer control of blood pressure than men

Objective: Diabetes is associated with a higher coronary heart disease (CHD) mortality in women compared with men. Less aggressive control of the CHD risk factors in women can contribute to this excess mortality. Because hypertension has a high prevalence in subjects with diabetes, we compared the control of this risk factor between men and women. Methods: This was a retrospective cohort study comparing blood pressure levels and trends over a 1-year period between men and women with diabetes receiving primary care. Using a chronic disease registry database, subjects with type 1 and type 2 diabetes, aged ≥18, were identified for inclusion. Mean weighted systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated for subjects with multiple longitudinal readings. Subjects were classified into four blood pressure control categories based on the mean weighted blood pressure. Comparisons were made between men and women before and after controlling for baseline characteristics. Results: A total of 3181 subjects (46% women) were included in the study. More women than men were in the moderate and severely elevated blood pressure categories (40% and 6% compared with 32% and 5%, respectively, p < 0.001). The unadjusted mean SBP was 3 mm Hg higher in women (139 mm Hg in women compared with 136 in men, p < 0.001). These differences remained significant after controlling for baseline variables. Conclusions: In subjects with diabetes receiving medical care, women had poorer control of blood pressure and a significantly higher mean SBP compared with men. These findings might partially explain the excess CHD mortality in women with diabetes.