Approved Research

Multifactorial Cardiovascular Disease Risk Assessment Among Patients with Type 2 Diabetes

Lay summary

By 2018, the most common reason for death in the United Kingdom is ischemic cardiovascular disease, primarily heart attack and stroke. Individuals with type 2 diabetes mellitus, characterized as elevated levels of blood glucose due to insufficient insulin production or insulin resistance, are at much higher risk and thus more likely to experience or even die from heart attack or stroke.

Researchers have investigated different approaches to lower cardiovascular risk among type 2 diabetes patients, including controls of blood glucose, blood pressure, and blood lipids through different therapies. However, the concept of "composite control", meaning controlling multiple factors at the same time, is under-appreciated in clinical practice. Previous research has suggested that type 2 diabetes patients will have up to 62% lower risk of heart disease if they are at composite target risk factor control. Moreover, lifestyle modification may provide additional cardiovascular benefits beyond current clinical risk factors, but the magnitude remains unclear.

The current project will aim to estimate the composite risk factor control rate in the UK biobank type 2 diabetes patients, and how it affects their risk of cardiovascular events during more than 10 years of follow-up. Moreover, this study will also determine the role of healthy behaviors, namely physical exercise, smoking status, diet patterns, and body weight control, in addition to clinical factors, in preventing cardiovascular events in UK Biobank type 2 diabetes patients, thus providing the scientific evidence to advocate for healthy behaviors among this high-risk population.

The proposed duration of this project will be 3 years. Our goal is to publish the current project in a peer-reviewed journal once completed.

The public health impact of the current study is to identify and advocate the significant role of multiple risk factors control, including healthy behaviors, in reducing heart disease risk among type 2 diabetes patients, with the ultimate goal to improve long term health and lower cardiovascular mortality in this high-risk population in the UK.