Associations of updated cardiovascular health metrics, including sleep health, with incident diabetes and cardiovascular events in older adults with prediabetes: A nationwide population-based cohort study

Abstract

AimsTo investigate the association of updated cardiovascular health (CVH) metrics, including sleep health, with the risk of diabetes and major adverse cardiovascular events (MACE) in older adults with prediabetes. MethodsA total of 7,948 older adults with prediabetes aged ≥ 65 years were included in this study. CVH was assessed using seven baseline metrics according to the modified American Heart Association recommendations. ResultsDuring a median follow-up time of 11.9 years, 2,405 (30.3%) cases of diabetes and 2,039 (25.6%) MACE were recorded. Compared with the poor composite CVH metrics group, the multivariable-adjusted hazard ratios (HRs) in the intermediate and ideal composite CVH metrics groups were respectively 0.87 (95% confidence intervals [CI] = 0.78–0.96) and 0.72 (95% CI = 0.65–0.79) for diabetes events and 0.99 (95% CI = 0.88–1.11) and 0.88 (95% CI = 0.79–0.97) for MACE. The ideal composite CVH metrics group had a lower risk of diabetes and MACE in older adults aged 65–74 years, but not in those aged ≥ 75 years. ConclusionsIdeal composite CVH metrics in older adults with prediabetes were associated with a lower risk of diabetes and MACE.