Breslow’s Health Practice Index (HPI) includes recommendations for a healthy lifestyle and is composed of 7 simple lifestyle factors (sleep, breakfast, snacks, body mass index (BMI) , physical activity, drinking alcohol, and smoking status) . Cardiovascular health metrics (CVHMs) defined according to the American Heart Association are composed of lifestyle factors and clinical laboratory values (smoking status, BMI, physical activity, diet, systolic blood pressure <120 mmHg and diastolic blood pressure <80 mmHg, total cholesterol <200 mg/dl, and fasting blood glucose <100 mg/dl) . To clarify the impacts of HPI or CVHMs on incident CVD according to glucose tolerance status, we analyzed a nationwide claims-based database of 128,290 people included from 2008-aged 20-72 y in Japan (86,279 with normal glucose tolerance; 36,1with prediabetes; 5,9with diabetes) . HPI and CVHMs were divided into three categories (high, middle, and low) based on the number of ideal health factors present (Table) . Multivariate Cox regression analysis showed that people with prediabetes with an HPI of ≥5 or people with prediabetes and diabetes who had ≥5 CVHMs had no increased risks for CVD compared with those in the high HPI/CVHMs category for normal glucose tolerance (Table) .

In summary, not only to follow a healthy lifestyle but to achieve laboratory treatment targets may be essential in people with diabetes.


T.Iijima: None. T.Yamada: None. S.Kodama: None. H.Sone: Research Support; Astellas Pharma Inc., Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Novo Nordisk, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Takeda Pharmaceutical Company Limited. K.Fujihara: None. M.H.Yamada: None. M.Yamamoto: None. T.Osawa: None. Y.Matsubayashi: None. T.Sato: None. Y.Yaguchi: None. M.Iwanaga: None.

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