The link between between heart health and the risk of diabetes differs greatly between different ethnic groups, according to new research.
And as many as three out of five cases of diabetes may be down to poor cardiovascular health.
Researchers examined the links between type 2 diabetes and cardiovascular health within a multi-ethnic population in the United States from 2002 to 2012.
Cardiovascular disease (CVD) is the leading cause of disability, poor health and death in people with diabetes, who have a mortality rate from the illness three times higher than that among non-diabetics.
The American Heart Association (AHA) defined the concept of ideal cardiovascular health (ICH) in 2010 based on seven health factors – including blood pressure, dietary intake, tobacco use, physical activity and body-mass index (BMI).
The new study is the first of its kind to assess the association of baseline ICH with diabetes within a multi-ethnic population, and used a sample of 6,814 men and women, aged 45-84 drawn from four ethnic groups.
Each person’s seven baseline ICH metrics were marked as “poor”, “intermediate”, or “ideal” and scores were then compared with diabetes rates and population characteristics.
Only one in four study participants were found to have attained four or more of the ICH goals, but among racial minorities, this proportion was just one in six, with differences not solely limited to lifestyle factors.
Hispanic Americans and African Americans were found to have significantly higher BMI, systolic blood pressure and fasting glucose compared to non-Hispanic whites.
Rates of diabetes developed during the follow-up period of the study were highest in Hispanic American and African American populations at 15.3 and 12.3 cases per 1000 people per year respectively. This was compared to 11.6 Chinese Americans and just 8.3 among non-Hispanic whites.
Every ICH goal that was achieved in both the cohort as a whole as well as the individual race/ethnic groups resulted in lower rates of incident diabetes.
Participants categorised as having “ideal” cardiovascular health had a 75 per cent lower diabetes incidence than individuals whose cardiovascular health was considered to be “poor”.
It was also found that the reduction in diabetes risk between “ideal” and “poor” cardiovascular health was greater among non-Hispanic whites and Chinese Americans than it was for African and Hispanic Americans.
Dr Joshua Joseph, of Johns Hopkins University School of Medicine in the Us, said: “The lower prevalence of ICH, combined with lower magnitude of diabetes risk reduction with ICH in African Americans and Hispanic Americans, provides a potential explanation and intervention target for the disparities in diabetes prevalence among these groups.”
He said the findings, published in the journal Diabetologia, also illustrate the particular importance of tailoring health messages and interventions to tackle the increased burden of diabetes in racial/ethnic minority populations.
