A new study suggests that a genetic risk score based on a person’s DNA can help predict the likelihood of high blood pressure leading to heart disease or stroke in people with Type 2 diabetes.
The research, published in the American Heart Association’s journal Hypertension, indicates that this tool could be particularly useful for people who are newly diagnosed with Type 2 diabetes or those with prediabetes.
It is already well known that adults with Type 2 diabetes are about twice as likely to experience a heart attack or stroke compared to those without diabetes. Doctors typically assess heart disease risk by looking at factors such as blood pressure, cholesterol, and blood sugar levels.
However, this study aimed to determine whether genetic factors linked to high blood pressure could provide additional insights into a person’s risk of developing serious cardiovascular complications.
Dr. Pankaj Arora, the study’s lead author and a cardiology researcher at the University of Alabama at Birmingham, explained the importance of this approach: “Some people with Type 2 diabetes may have a higher genetic risk for high blood pressure, which could increase their chances of having a heart attack, stroke, or even dying from cardiovascular disease.”
To explore this connection, researchers analyzed the health records of 6,335 participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, all of whom had Type 2 diabetes and high blood pressure.
The study group included 37% women and was racially diverse, with 15% African American, 6% Hispanic, 70% white, and 9% in other racial or ethnic categories. Participants were followed for 3.5 years.
Scientists compared each participant’s DNA to a database of over 1,000 genetic variants known to affect blood pressure. The more genetic matches a person had, the higher their genetic risk score for hypertension.
The findings revealed that people with a higher genetic risk score were significantly more likely to experience heart problems or strokes:
- For each increase in genetic risk, the likelihood of heart disease or stroke rose by 12%.
- This risk remained the same even for participants who were taking medication to manage their blood sugar.
These results suggest that genetic factors play a key role in determining cardiovascular risk, even beyond traditional treatments for diabetes. However, researchers noted that further studies are needed to determine if genetic risk scores could be useful for people without diabetes as well.
Interestingly, the study also found that differences in genetic risk scores did not fully explain why aggressive blood sugar control—through medication, insulin, diet, and exercise—did not significantly reduce cardiovascular risk in people with long-standing Type 2 diabetes. This remains an open question for future research.
Dr. Arora emphasized that genetic risk scores could be most useful for people who have been newly diagnosed with Type 2 diabetes. “A genetic risk score could help identify those who need more intensive lifestyle changes, such as improving diet, increasing exercise, and aggressively managing weight, blood pressure, and smoking cessation,” he explained.
Dr. Eduardo Sanchez, the American Heart Association’s chief medical officer for prevention, reinforced the importance of managing multiple risk factors. “If you have Type 2 diabetes, there is a lot you can do to reduce your risk for heart disease,” he said.
“In addition to controlling blood sugar, we encourage people to talk to their healthcare team about other risk factors, including their family history, and take steps to manage them.”
This study highlights how genetic insights could become a valuable tool in personalizing treatment plans for people with Type 2 diabetes, helping them reduce their risk of serious heart complications before they occur.
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The research findings can be found in Hypertension.
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