Combining Healthy Lifestyle Habits with GLP-1 Medications Reduces Cardiovascular Risk in Type 2 Diabetes Patients

People with Type 2 diabetes who combined healthy lifestyle habits with GLP-1 receptor agonist medications demonstrated significantly greater reduction in cardiovascular risk compared to those relying on medication alone, according to research to be presented at the American Heart Association's Scientific Sessions 2025. The study of more than 63,000 military veterans found that those adhering to at least six healthy lifestyle factors while taking GLP-1 RA medications had a 50% lower risk of major adverse cardiovascular events compared to participants who did not use these medications and followed three or fewer healthy lifestyle habits.

The research, conducted within the Million Veteran Program, examined data from veterans with Type 2 diabetes who had no previous history of heart attack, stroke, cancer or advanced chronic kidney disease. Researchers analyzed eight heart-healthy lifestyle factors including healthy eating, physical activity, not smoking, restful sleep, no-to-moderate alcohol intake, good stress management, social connection and support, and no opioid addiction. The study period spanned from 2011 to September 30, 2023, with 418,513 person-years of cumulative follow-up.

Lead study author Xuan-Mai Nguyen, M.D., Ph.D., a researcher with the Department of Veterans Affairs Boston Healthcare System, emphasized that lifestyle modifications remain the cornerstone for preventing and managing Type 2 diabetes. The findings suggest that people taking GLP-1 receptor agonists can further improve their heart health by maintaining healthy lifestyle habits. Additionally, the research indicates that even without access to GLP-1 RAs, adopting healthy lifestyle habits alone can still significantly lower cardiovascular risk.

The analysis revealed several key findings. Participants adhering to all eight healthy lifestyle habits showed a 63% lower risk of major cardiovascular events compared to those following one or fewer habits. Veterans taking GLP-1 RA medications demonstrated a 20% lower risk of major cardiovascular events compared to non-users, consistent with prior research. Most significantly, the combination of medication and lifestyle produced the strongest protective effect against cardiovascular complications.

Chiadi E. Ndumele, M.D., Ph.D., FAHA, chair of the American Heart Association's Council on Lifestyle and Cardiometabolic Health, noted the powerful observations about the combined impact of healthy lifestyle and GLP-1 RA use on cardiovascular risk. While acknowledging potential confounding variables, Ndumele emphasized that the findings suggest healthy lifestyle truly complements the effects of GLP-1 RAs, indicating that healthcare professionals should emphasize both approaches for optimal patient outcomes.

The study's implications are particularly significant given that people living with Type 2 diabetes are twice as likely to die from cardiovascular disease, according to Know Diabetes by Heart, a collaborative initiative of the American Heart Association and the American Diabetes Association available at https://knowdiabetesbyheart.org. The incidence of Type 2 diabetes has more than doubled in the United States over the past 20 years, making effective prevention strategies increasingly important.

Study limitations include the observational nature of the data, the predominantly white male veteran population potentially limiting generalizability to more diverse groups, and the inability to predict cardiovascular risk changes for adults without Type 2 diabetes who take GLP-1 RA medications for obesity treatment. The research abstract will be presented at the American Heart Association's Scientific Sessions 2025 meeting in New Orleans, with full details available in the association's online program planner at https://professional.heart.org/en/meetings/scientific-sessions.