ArticleJACC. Advances2025
Changes in Cardiovascular Health at Midlife and Subsequent Cardiovascular Outcomes in Individuals With Diabetes.
Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Dietary Patterns and Cardiovascular Diseases in Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Observational Studies.Advances in nutrition (Bethesda, Md.) · 2026Pooled it
- Longitudinal Changes in Cardiovascular-Kidney-Metabolic Syndrome Stages and Their Impact on Outcomes: A Nationwide Cohort Study.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Whether improvements in cardiovascular health (CVH) in midlife mitigate cardiovascular disease (CVD) risk in patients with diabetes remains underexplored. Objectives: The aim of the study was to examine the relationships between changes in CVH during midlife and subsequent risks of CVD events and all-cause mortality among individuals with and without diabetes. Methods: The study utilized data from the Atherosclerosis Risk in Communities Study. CVH data were collected during visits 1 and 3 and the median follow-up was 23 years. CVH was based on ideal Life's Simple 7 metrics and categorized as low (0-2 metrics), moderate (3 or 4 metrics), and favorable CVH (5-7 metrics). Cox proportional hazards regression models were used to determine the association between changes in CVH and CVD outcomes. Results: Among the final sample (N = 8,741), 806 had diabetes (9.2%). Of those with diabetes, 62.3% had low CVH at both visits, 12.0% maintained moderate CVH, 15.0% showed improvement, and 10.3% experienced a decline in CVH. Only 0.4% maintained favorable CVH. Those with improved CVH had lower CVD event risks (HR: 0.69; 95% CI: 0.50-0.93), as did those who maintained moderate CVH (HR: 0.68; 95% CI: 0.50-0.94) or shifted from moderate to low CVH (HR: 0.60; 95% CI: 0.41-0.88). Similar patterns were observed for all-cause mortality. In comparison to participants without diabetes who maintained a favorable CVH trajectory at midlife, those with diabetes consistently displayed higher risks of CVD events and mortality, regardless of their CVH trajectory. Conclusions: For patients with diabetes, achieving or maintaining ideal CVH levels at midlife may help improve outcome; however, CVD risk is not completely mitigated by favorable CVH trajectories.
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