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Change in cardiovascular health and incident type 2 diabetes and prediabetes: The Whitehall II Study

Session Poster Session 3

Speaker Rachel Climie

Event : ESC Congress 2019

  • Topic : preventive cardiology
  • Sub-topic : Diabetes and the Heart
  • Session type : Poster Session

Authors : R Climie (Paris,FR), TT Van Sloten (Paris,FR), MC Perier (Paris,FR), M Tafflet (Paris,FR), A Fayosse (Paris,FR), A Dugravot (Paris,FR), A Singh-Manoux (Paris,FR), JP Empana (Paris,FR)

R Climie1 , TT Van Sloten1 , MC Perier2 , M Tafflet2 , A Fayosse3 , A Dugravot3 , A Singh-Manoux3 , JP Empana1 , 1University Paris-Descartes - Paris - France , 2INSERM 970, Department of Epidemiology - Paris - France , 3INSERM U1153 - Paris - France ,


Background. Most previous studies on cardiovascular health (CVH) and incident type 2 diabetes (T2D) used a single measure of CVH and none investigated the association with incident prediabetes. This study aimed to examine whether changes in CVH are associated with incident T2D and prediabetes. 

Methods. Within the prospective Whitehall II study, CVH was examined serially every 5 years from 1991/93 until 2015/16. Subjects with 0-2, 3-4 and 5-6 ideal metrics of CVH from the American Heart Association (non-smoking, and ideal levels of body mass index, physical activity, diet, blood pressure, and total cholesterol, fasting glycaemia was not considered),were categorized as having low, moderate or high CVH. 

Results. There were 6234 participants without prior cardiovascular disease and T2D  (mean age 49.8±6.0 years, 70% male) including 5015 who were additionally free of prediabetes (49.6±6.0 years, 67% male) at baseline. Over a median follow-up of 24.8 (IQR 24.0 to 25.2) years, 895 and 1703 incident cases of T2D and prediabetes occurred respectively. Change in CVH between 1991/93 and 2002/04 was calculated among 4470 participants without CVD and T2D in the interval, and among 2798 participants additionally free of prediabetes. In multivariate analysis, compared to those with stable low CVH, risk of T2D was lower in those with initially high CVH (HR=0.23; 0.09, 0.56), those who had persistently moderate CVH or changed from moderate to high CVH (moderate-moderate/high; HR=0.42; 0.33, 0.54), low-moderate/high (HR=0.50; 0.36, 0.69) and moderate-low (HR=0.63; 0.48, 0.83). Results were similar for prediabetes, but effect sizes were smaller.

Conclusions. Among participants without previous CVD, T2D or prediabetes, change in CVH was related to the risk of incident T2D and prediabetes.

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