Coronary risk factors in post‐menopausal type 2 patients: A case for oestrogen replacement therapy

We have explored detailed coronary artery disease risk factors in a group of 257 people with type 2 diabetes aged>50 years (130 women, 127 men) with a mean (SD) age of 66±8 years and diabetes duration of 9±7 years. Major coronary risk factors were highly adverse in women, in particular total cholesterol (6.1±1.3vs. 5.3±1.1 mmol/L, p < 0.0001), triglyceride (2.5±1.4 vs. 2.0±1.1 mmol/L, p < 0.05) and LDL‐cholesterol (3.8±1.0vs. 3.4±1.1 mmol/L, p < 0.005). HbA_1c (8.1±1.7vs. 7.5±1.6%, p < 0.005) and Body Mass Index (31.0±6.5 vs. 28.7±4.6, p < 0.005) were also significantly higher in women. Hypertension was more common (43% vs. 33%) and smoking rates lower (21% vs. 27%), but these differences were not significant. HDL‐cholesterol, lipoprotein(a) levels and urinary albumin:creatinine ratio (ACR) were similar between sexes. Angina was more common in women than men (38% vs. 26%, p < 0.05). Our results show that female type 2 diabetic patients of post‐menopausal age have significantly adverse lipid profiles compared to age and duration‐matched male counterparts. In addition, they have poor glycaemic control, and a greater degree of obesity. These results raise the question of whether hormone replacement therapy (HRT) may be beneficial in these patients.