A groundbreaking study conducted by researchers at the NIHR Leicester Biomedical Research Centre (BRC) has revealed that women with type 2 diabetes face nearly twice the risk of hidden heart damage compared to men. The study, which is one of the most detailed investigations into coronary microvascular dysfunction (CMD), highlights serious sex-specific disparities in cardiovascular risk among people who show no outward symptoms of heart disease.

CMD refers to early and often undetectable damage in the heart’s smallest blood vessels, leading to reduced blood flow and potential future complications like heart failure. Utilizing advanced MRI scans and data from four major studies, researchers found that 46% of women with type 2 diabetes had signs of CMD, compared to just 26% of men.

“What’s concerning is that these individuals showed no symptoms like chest pain or shortness of breath. Yet, the scans revealed silent heart issues, particularly among women,” said Professor Gerry McCann, lead investigator and NIHR Research Professor at the University of Leicester.

Dr. Gaurav Gulsin, a co-author and NIHR Clinical Lecturer, emphasized the importance of personalized approaches, stating: “In women, CMD was most strongly associated with a higher BMI, whereas in men, elevated blood pressure was the dominant risk factor. This shows the need for sex-specific prevention strategies and re-evaluation of cardiovascular risk assessment models.”

The findings reflect the power of cross-disciplinary collaboration, as the study brought together the expertise of the Cardiovascular, Lifestyle, and Diabetes teams at the NIHR Leicester BRC. Professor Melanie Davies CBE, Director of the BRC and co-author of the publication, noted, “These results not only advance our understanding of diabetes-related heart complications but also reinforce the need for early intervention strategies. For instance, weight loss in women and blood pressure management in men could significantly delay or prevent progression to heart failure.”

This pivotal research is expected to influence future guidelines on how cardiovascular risks are assessed and managed in patients with type 2 diabetes, especially those without obvious symptoms.