A study found that individuals with prediabetes or diabetes who had five or more ideal cardiovascular health metrics (ICVHMs) had lower or no significant excess cardiovascular disease (CVD) risks compared with participants with normal glucose regulation.
Researchers used data from the nationwide, population-based, prospective China Cardiometabolic Disease and Cancer Cohort Study that included 20 communities from various geographic regions in China. The study involved 111,765 participants who did not have CVD or cancer at baseline. Data were analyzed between 2011 and 2016.
Prediabetes and diabetes were defined according to the American Diabetes Association 2010 criteria. Seven ICVHMs were adapted from the American Heart Association recommendations.
The final cohort included:
- 24,881 people (22.3%) with normal glucose regulation
- 61,024 people (54.6%) with prediabetes
- 25,860 people (23.1%) with diabetes
Compared with participants with normal glucose regulation, participants with prediabetes had a multivariable-adjusted hazard ratio for CVD of 1.34 (95% CI, 1.16-1.55) if they had one or less ICVHM and 0.57 (95% CI, 0.43-0.75) if they had at least five ICVHMs. Among participants with diabetes, the hazard ratios for CVD were 2.05 (95% CI, 1.76-2.38) and 0.80 (95% CI, 0.56-1.15), respectively.
The association between ICVHM and CVD was more prominent for participants aged less than 55 years compared with those aged 65 years or older. Compared with those with normal glucose regulation, among the younger cohort with prediabetes and at least five ICVHMs, the hazard ratio (HR) was 0.32 (95% CI, 0.16-0.63); the HR for those with one or less ICVHM was 1.58 (95% CI, 1.13-2.21). Meanwhile, for those with diabetes and at least five ICVHMs, the HR was 0.99 (95% CI, 0.44-2.26); the HR for those with one or less ICVHM HR was 2.46 (95% CI, 1.71-3.54).
Among the older cohort, those with prediabetes and at least five ICVHMs had an HR of 0.80 (95% CI, 0.50-1.26); those with one or less ICVHM had an HR of 1.01 (95% CI, 0.79-1.31). Among those with diabetes and at least five ICVHMs, the HR was 0.79 (95% CI, 0.46-1.35); for those with one or less ICVHM, the HR was 1.73 (95% CI, 1.36-2.22; P values for interaction ≤0.02).
The HR for CVD per additional ICVHM was 0.82 (95% CI, 0.79-0.86) among participants with prediabetes and 0.85 (95% CI, 0.80-0.89) among participants with diabetes. Read more
The study was published in JAMA Cardiology.