Favorable cardiovascular health was associated with a significantly reduced risk of diabetes complications (HR 0.35) and all-cause mortality (HR 0.53) compared to unfavorable cardiovascular health in people with type 2 diabetes.
Cohort (n=33,236)
Yes
Does favorable cardiovascular health reduce diabetic complications and all-cause mortality in people with type 2 diabetes?
Maintaining favorable cardiovascular health metrics significantly reduces the risk of diabetic complications and all-cause mortality, and extends life expectancy in patients with type 2 diabetes.
Effect estimate: HR 0.35 (95% CI 0.26-0.47)
Absolute Event Rate: 2.11% vs 9.8%
BACKGROUND: We aimed to assess the impact of healthy cardiovascular health (CVH) on diabetic complications, mortality, and life expectancy among people with type 2 diabetes and to explore whether inflammation marker mediate these associations. METHODS: This prospective cohort study included 33,236 participants (aged 40-72) with type 2 diabetes from the UK Biobank with annual follow-up from 2006 to 2010 to 2020. Type 2 diabetes was ascertained from self-report, glycated hemoglobin ≥ 6.5%, hospital inpatient registry, or glucose-lowering medication use. Information on mortality was derived from the national death registry. Favorable CVH metrics consisted of non-smoker, regular physical activity, a healthy diet, non-overweight, untreated resting blood pressure 3 mg/L). Data were analyzed using Cox regression models, flexible parametric survival models, and mediation models. RESULTS: During the follow-up (median: 11.7 years), 3133 (9.4%) cases of diabetes complications and 4701 (14.1%) deaths occurred. Compared to unfavorable CVH, favorable CVH was associated with a reduced risk of diabetes complications (HR, 0.35; 95% CI, 0.26-0.47) and all-cause mortality (HR, 0.53; 95% CI, 0.43-0.65). In participants with unfavorable CVH, life expectancy at age 45 had a significantly reduction of 7.20 (95% CI, 5.48-8.92) years compared to those with a favorable CVH. Among people with type 2 diabetes, the proportions of diabetes complications and all-cause mortality that would be reduced by promoting the favorable CVH was 61.5% and 39.1%, respectively. CRP level mediated 14.3% and 29.7% of the associations between CVH and diabetic complication and all-cause mortality, respectively. CONCLUSION: A favorable CVH was associated with lower risk of diabetes complications and mortality risk, and was associated with a longer life expectancy among people with type 2 diabetes. This association may be in part accounted for by inflammatory processes. Our findings highlight the importance of favorable CVH for the prevention of diabetic complications and all-cause mortality among people with type 2 diabetes, and underscores the need to monitor inflammation among people with unfavorable CVH.
Zhang et al. (Fri,) conducted a cohort in Type 2 diabetes (n=33,236). Favorable cardiovascular health (4 or more ideal metrics) vs. Unfavorable cardiovascular health (0 or 1 ideal metric) was evaluated on Diabetes complications (HR 0.35, 95% CI 0.26-0.47). Favorable cardiovascular health was associated with a significantly reduced risk of diabetes complications (HR 0.35) and all-cause mortality (HR 0.53) compared to unfavorable cardiovascular health in people with type 2 diabetes.