© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) 1 Protectng women heart in type 2 diabetes mellitus: why, how and 1 when? 2 3 Mitja Lainscak 1,2* , Cornelia Margineanu 3 , Ovidiu Chioncel 3,4 , Giuseppe M.C. Rosano 5,6 4 5 1. Division of Cardiology, General Hospital Murska Sobota, 9000 Murska Sobota, Slovenia. 6 2. Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia. 7 3. University of Medicine Carol Davila, Bucharest, Romania 8 4. Emergency Insttute for Cardiovascular Diseases 'Prof. C.C. Iliescu', Bucharest, Romania. 9 5. St George’s Hospital NHS Trust University of London, Cardiology Clinical Academy Group, London, 10 UK. 11 6. Department of Medical Sciences, Centre for Clinical and Basic Research IRCCS San Rafaele Pisana, 12 Rome, Italy 13 14 *Correspondence author: Mitja Lainscak - General Hospital Murska Sobota, Division of Cardiology, 15 mitja.lainscak@guest.arnes.si 16 17 This editorial refers to “Higher risk of adverse cardiovascular outcomes in females with type 2 diabetes Mellitus: 18 An Umbrella review of systematc reviews” by Clyve Yu Leon Yaow and 19 others, htps://doi.org/10.1093/eurjpc/zwad133 20 21 Cardiovascular diseases are the leading global cause of morbidity and mortality in adults for 22 decades (1). Through major advances in acute and chronic management, we are witnessing the transi ton 23 in some countries with malignant disease taking the lead, but more granular view reveals this is largely 24 limited to men, as only Danish and Israeli women share these benefts with men (2). Several reasons can 25 contribute to higher cardiovascular mortality in women, including atypical clinical presentaton, more 26 comorbidites, and lower rates of medical referral (3) – Figure. In addi ton, women are less likely to be 27 prescribed with medicaton to prevent incident cardiovascular disease. This was nicely demonstrated by 28 Zhao M et al (4) in a systematc review and meta-analysis that included 2.2 million patents, where women 29 were less likely prescribed with statns, aspirin, and neurohormonal medicaton than men. 30 ACCEPTED MANUSCRIPT Downloaded from https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwad335/7331930 by guest on 30 October 2023