Diabetes increases the likelihood that women will develop an abnormal heart rhythm that can lead to stroke or heart failure, according to a Portland-based Kaiser Permanente researcher.
Diabetes increases the likelihood that women will develop atrial fibrillation by 26 percent, said Greg Nichols, lead author of a study published in the October issue of Diabetes Care.
Nichols is an investigator at the Kaiser Permanente Center for Health Research in north Portland.
"Men with diabetes are also at higher risk, but the association between the two conditions is not as strong," Nichols said in a news release. "For men, obesity and high blood pressure are bigger risk factors from diabetes."
In a telephone conversation after the study's release, Nichols said that women typically have lower rates than men of cardiovascular disease.
"With diabetes, the risk is equal," he said.
Atrial fibrillation is caused by a disorder of the heart's electrical signals. The two upper chambers of the heart beat irregularly and too fast, causing blood to pool and clot. If the clot travels out of the heart and becomes lodged in an artery or in the brain, it can cause a stroke.
"That's the main thing you have to worry about," Nichols said. "It can leave you tired and short of breath as well, so it is a quality of life issue."
The seven-year study involved nearly 35,000 Kaiser Permanente patients in Oregon and Washington; half had diabetes.
At the start of the study, 3.6 percent of those with diabetes had atrial fibrillation, vs. only 2.5 percent of the non-diabetic patients -- a difference of 44 percent.
During the study period, diabetics were more likely to develop the irregular heartbeat. But after controlling for factors like obesity, high blood pressure and age, the increased risk was only significant among women. Women with diabetes were 26 percent more likely than non-diabetics to develop atrial fibrillation.
Since the researchers analyzed numbers -- Kaiser has the world's largest civilian system of electronic health records -- they were able to determine that women were more vulnerable to this particular risk, but not why
"This type of study can't really do that," Nichols said. "This is more of an awareness paper than a treatment" study.
About 2.2 million Americans have been diagnosed with atrial fibrillation; many more have it but don't know it. Diabetes affects more than 23 million Americans -- and, according to the study, nearly 4 percent (about 1 million) have atrial fibrillation.
Other studies have found that diabetics are more likely to have atrial fibrillation, but Kaiser says this is the first large study to isolate the effect of diabetes and determine that it is an independent risk factor for women.
"The gender differences need to be looked at more closely because they could have significant implications for how we treat diabetes in men and women," Dr. Sumeet Chugh, co-author and associate director of the Cedars-Sinai Heart Institute in Los Angeles, said in the report.
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