Low BP and HbA1c protective against incident CVD in Type-1 D
Data from 2313 participants from the EURODIAB Prospective Complications Study were analyzed. All had type 1 diabetes (51% men, mean±SD age 32±9 years). Seven cardiovascular health metrics were studied—smoking, BMI, physical activity, a diet score, total cholesterol/HDL-cholesterol ratio, combined systolic and diastolic BP and HbA1c—divided into favorable/less favorable categories. Cox proportional hazards models were used to calculate HRs (95% CIs) of incident CVD for each metric. Clusters were made by scoring each individual by the number of favorable metrics.

A total of 163 people developed incident CVD during a mean±SD follow-up of 7.2±1.3 years. Participants with more favorable HbA1c levels of <57 m mol/mol (<7.4%) had a 37% significantly lower CVD risk than those with a less favorable HbA1c (HR [95% CI] 0.63 [0.44, 0.91]), and participants with a more favorable BP (systolic BP <112 mmHg and diastolic BP <70 mmHg) had a 44% significantly lower CVD risk than participants in the less favorable BP group (HR [95% CI] 0.56 [0.34, 0.92]). There was a dose–response relation with a lower HR observed with greater clustering of more favorable metrics: people with four or more favorable metrics had an HR of 0.37 (95% CI 0.18, 0.76), adjusted for sex and age at diabetes diagnosis, compared with those with no favorable metrics.

Low HbA1c and low BP were protective cardiovascular health metrics in our study of people with type 1 diabetes. Targeting all cardiovascular health metrics could be more effective in preventing CVD than targeting single metrics.

Source: Source: https://link.springer.com/article/10.1007/s00125-022-05698-2
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