Lower HbA1c, blood pressure protect against CVD in type 1 diabetes
Click Here to Manage Email Alerts
Both lower HbA1c and lower blood pressure were protective cardiovascular health metrics for adults with type 1 diabetes, according to findings published in Diabetologia.
For the prospective study, Soraya Soulimane, MD, of the department of medical and clinical psychology in the Center of Research on Psychology in Somatic Diseases at Tilburg University in the Netherlands, and colleagues sought to evaluate cardiovascular disease risk reduction in type 1 diabetes for people with favorable CV health metrics and to assess whether clustering of these metrics was associated with lower CVD risk.
The analysis included data from 2,313 adults with type 1 diabetes (51% men; mean age, 32 years) from the EURODIAB Prospective Complications Study. The researchers divided patients into favorable and less favorable categories according to seven CV health metrics: smoking, BMI, physical activity level, a diet score, total cholesterol/HDL-cholesterol ratio, combined systolic and diastolic BP, and HbA1c.
During follow-up (mean, 7.2 years), 163 patients developed incident CVD.
Compared with patients with less favorable HbA1c, those with more favorable levels of < 57 mmol/mol (< 7.4%) had a reduced risk for CVD (HR = 0.63; 95% CI, 0.44-0.91), whereas those with more favorable BP levels (systolic BP, < 112 mm Hg; diastolic BP, < 70 mm Hg) had a lower CVD risk than those in the less favorable BP group (HR = 0.56; 95% CI, 0.34-0.92).
The researchers reported a dose-response relationship in which the higher the number of favorable CV health metrics, the lower the risk for incident CVD (P for trend < .0001). In a model adjusted for sex and age at diabetes diagnosis, patients with four or more favorable CV health metrics had an HR of 0.37 (95% CI, 0.18-0.75) for CVD, whereas those with three had an HR of 0.49 (95% CI, 0.24-1). With each one-unit increase in the number of favorable metrics, the HR was 0.77 (95% CI, 0.68-0.88).
The HRs remained comparable after further adjustment for retinopathy, nephropathy and neuropathy.
“Low values of HbA1c and BP were protective against incident CVD and targeting a higher number of favorable cardiovascular health metrics that include lifestyle factors could significantly reduce the risk of CVD in type 1 diabetes,” the researchers concluded. “More research is necessary in large populations to study these relationships for different age classes and durations of diabetes to better identify the type 1 diabetic population for whom these measures should be used, and to determine an appropriate threshold for each cardiovascular health metric. Further studies should investigate which clusters of factors are important in promoting cardiovascular health.”
Collapse
Read more about
Click Here to Manage Email Alerts