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

People with Type 2 diabetes who combined healthy lifestyle habits with GLP-1 receptor agonist medications experienced significantly greater reduction in cardiovascular risk compared to those using medication alone, according to research to be presented at the American Heart Association's Scientific Sessions 2025. The study analyzed data from more than 63,000 military veterans with Type 2 diabetes who had no previous history of heart attack, stroke, cancer or advanced chronic kidney disease.

Researchers found that participants who took GLP-1 RA medications and adopted at least six healthy lifestyle habits had a 50% lower risk of major cardiovascular events compared to those who did not take GLP-1 RA medications and followed three or fewer healthy lifestyle habits. The study examined 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.

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 with Type 2 diabetes taking GLP-1 receptor agonists can improve their heart health even more by adding and maintaining healthy lifestyle habits. The research also indicates that if someone does not have access to GLP-1 RAs, adopting healthy lifestyle habits can still lower the risk of stroke, heart attack or death from heart-related issues.

The analysis revealed several key findings. Participants adhering to all eight healthy lifestyle habits had a 63% lower risk of major cardiovascular events compared to those following one or fewer habits. Veterans taking GLP-1 RA medications had a 20% lower risk of major cardiovascular events compared to those not using these medications, consistent with prior research. When examined individually, all healthy lifestyle factors were independently associated with lower likelihood of major adverse cardiovascular events.

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. He emphasized that rather than medications versus lifestyle, health care professionals should emphasize both to achieve the best clinical outcomes for patients. The study utilized data from the Million Veteran Program, a national program that studies how genes, lifestyle, military experiences and exposures affect health and wellness in U.S. veterans, with information gathered from medical records, biospecimens and self-reported surveys.

Study limitations include that the estimations were based on observational data and the study group primarily consisted of white male veterans, so findings may not be applicable to more diverse populations. The research also does not predict how cardiovascular risk may change for adults without Type 2 diabetes who take GLP-1 RA medications to treat obesity. The study period spanned from 2011 to September 30, 2023, with 418,513 person-years of follow-up. Additional information about the study is available in the American Heart Association's Scientific Sessions 2025 Online Program Planner at https://professional.heart.org/en/meetings/scientific-sessions.