In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

Study highlights the importance of heart health for preventing diabetes

Diabetes and the Heart
Risk Factors and Prevention

Sophia Antipolis, 29 September 2021:  Heart healthy middle-aged adults are less likely to develop type 2 diabetes during their lifetime, according to a study published on World Heart Day in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).1

The research found that the importance of favourable cardiovascular health was apparent regardless of an individual’s genetic likelihood of developing type 2 diabetes. Favourable cardiovascular health was defined as having a healthy body weight, blood pressure, and cholesterol, not smoking, eating a balanced diet, and being physically active.

It is estimated that 463 million adults have diabetes and that 10% of global health expenditure is spent on the condition (USD 760 billion).2

Study author Dr. Fariba Ahmadizar of Erasmus University Medical Centre, Rotterdam, the Netherlands, said: “While genetics do contribute to the probability of developing type 2 diabetes, the findings indicate that maintaining healthy lifestyle habits, and especially having a healthy body weight, can help lower the lifetime risk of the condition.”

The study included 5,993 participants of the population-based Rotterdam Study who were free of type 2 diabetes at baseline. The average age was 69 years and 58% were women. Participants received a cardiovascular health score of 0 to 12 according to body mass index, blood pressure, blood cholesterol, smoking status, diet and physical activity at baseline, with higher scores corresponding to better cardiovascular health. Participants were then divided into three categories of cardiovascular health according to their score: poor (0-5), intermediate (6-7) and ideal (8-12).

To assess genetic predisposition to type 2 diabetes, the researchers used 403 independent genetic variants related to the condition to calculate a genetic risk score. Participants were then categorised as low, intermediate or high genetic risk according to their score.

A total of 869 individuals developed type 2 diabetes during 69,208 person-years of follow-up. The researchers estimated and compared the lifetime risk for type 2 diabetes within the cardiovascular health and genetic risk categories.

Looking at cardiovascular health alone, the researchers found that the remaining lifetime risk of type 2 diabetes was lower in those with better heart health. For example, at age 55, participants with ideal cardiovascular health had a 22.6% risk of developing type 2 diabetes in their lifetime, compared to 28.3% and 32.6% risks for those with intermediate and poor cardiovascular health, respectively.

When genetic risk was taken into account, the lifetime risk for type 2 diabetes was still lower in those with better cardiovascular health. At age 55, for example, the remaining lifetime risk of diabetes in the high genetic risk group was 23.5% for those with ideal cardiovascular health, compared to 33.7% and 38.7% for those with intermediate and poor cardiovascular health, respectively. The same relationships were seen within the low and intermediate genetic risk groups.

Dr. Ahmadizar said: “Our results highlight the importance of favourable heart health in preventing type 2 diabetes among middle-aged adults regardless of whether they are genetically at high or low risk of the condition. In other words, a healthy lifestyle is associated with a significantly lower risk of type 2 diabetes within any genetic risk category. The findings applied equally to men and women and indicate that healthy habits in midlife are an effective strategy for avoiding diabetes later on.”



Notes to editor

ESC Press Office
Tel: +33 (0) 7 8531 2036

Follow us on Twitter @ESCardioNews 


Funding: Erasmus MC and Erasmus University Rotterdam; Netherlands Organization for Scientific Research; Netherlands Organization for Health Research and Development (ZonMw); Research Institute for Diseases in the Elderly; Netherlands Genomics Initiative; Netherlands Ministry of Education, Culture and Science; Netherlands Ministry of Health, Welfare and Sports; European Commission; and Municipality of Rotterdam; ZonMw VENI grant (91616079—M.K.). This manuscript is also part of a project that has received funding from the Innovative Medicine Initiative 2 Joint Undertaking under grant agreement No 875534. This Joint Undertaking support from the European Union’s Horizon 2020 research and innovation programme and EFP IA and T1D Exchange, JDRF, and Obesity Action Coalition. We would also like to thank the China Scholarship Council for the scholarship to K.W.


Disclosures: None declared.



1Wang K, Kavousi M, Voortman T, et al. Cardiovascular health, genetic predisposition, and lifetime risk of type 2 diabetes. Eur J Prev Cardiol. 2021. doi:10.1093/eurjpc/zwab141.

Link will go live on publication:

2International Diabetes Federation Diabetes Atlas, 9th edition 2019:


Aboutthe European Journal of Preventive Cardiology
The European Journal of Preventive Cardiology is the world's leading preventive cardiology journal, playing a pivotal role in reducing the global burden of cardiovascular disease.

About the European Society of Cardiology

The ESC brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people to live longer, healthier lives.