Simple Lifestyle Changes Could Slash Heart Attack Risk for Millions, Scientists Report
Remission from prediabetes through diet and exercise linked to decades-long reduction in cardiovascular events, researchers say.
A new analysis of long-running trials published in The Lancet Diabetes & Endocrinology shows that achieving prediabetes remission through diet and physical activity may cut the risk of cardiovascular death or hospitalization for heart failure by about 58% over decades. The findings come from two large, population-based studies that tracked adults with prediabetes across different continents and health systems, suggesting that restoring normal blood sugar levels could yield long-lasting heart protection.
The research draws on data from a 20-year American study and a 30-year Chinese study in which participants were coached to lower blood sugar through lifestyle changes focused on diet and weight loss. In both cohorts, researchers compared those whose blood sugar returned to the normal range (remission) with those who remained in the prediabetes range (non-remission). They then assessed outcomes related to heart health, specifically deaths from heart disease and hospitalizations for heart failure, along with other major cardiovascular events. The remission group showed a markedly lower risk on these measures, and the benefits persisted for decades after the programs concluded. In practical terms, those who reached prediabetes remission reduced their risk of a heart event by more than half compared with peers who did not reach remission.
"Reaching prediabetes remission is linked to a decades-long benefit, halving the risk of cardiovascular death or hospitalization for heart failure in diverse populations," the researchers wrote in the publication, underscoring the potential for a new approach to cardiovascular prevention. This finding aligns with a growing emphasis on early, proactive measures to reverse elevated blood sugar before chronic disease takes hold.
In an interview with Fox News Digital, Dr. Andreas Birkenfeld, study co-author and professor of medicine at the University Hospital Tübingen in Germany, reiterated that reaching prediabetes remission is not only relevant for reducing progression to type 2 diabetes but may also be associated with meaningful reductions in heart attack risk, cardiac death and heart failure. "Importantly, this underscores that prediabetes is a modifiable stage where timely, evidence-based interventions (especially lifestyle measures, and in selected cases, medication) can make a real difference," he added. "Reaching prediabetes remission is linked to a decades-long benefit, halving the risk of cardiovascular death or hospitalization for heart failure in diverse populations." Birkenfeld also noted that the study’s design limits the ability to draw causal conclusions, as the trials were not originally designed to measure cardiovascular outcomes, and unmeasured lifestyle and health factors could influence results.
The researchers acknowledged several limitations. Because the trials were observational with respect to cardiovascular outcomes, the analysis shows associations rather than proof of causation. Differences across populations, variations in risk factor management, and the lack of randomized assignment for heart outcomes may have influenced the observed reductions in cardiovascular risk. The authors emphasize that while the data are encouraging, they do not establish a direct cause-and-effect relationship between prediabetes remission and fewer heart events.
For patients and clinicians, the findings highlight prediabetes as a potentially reversible stage that warrants proactive management. Birkenfeld suggested a practical set of questions that patients might bring to their doctors: What is my current status? What is my personal cardiovascular risk? What is my target blood glucose level? How often should I be tested for blood sugar and other risk factors such as blood pressure, cholesterol, kidney function, or sleep apnea? And if lifestyle changes are not sufficient, could medications be appropriate, and what are their benefits and downsides? These conversations, the researchers say, should be part of a broader strategy to prevent heart disease in people with prediabetes.
Prediabetes affects a substantial portion of the U.S. adult population. About 98 million American adults are estimated to have prediabetes, according to the Centers for Disease Control and Prevention, with eight in ten unaware that they have the condition. Health experts stress that early identification and sustained lifestyle changes—such as adopting a balanced diet, increasing physical activity and achieving weight loss goals—can have meaningful impacts on long-term heart health.
The study’s implications extend beyond individual risk reduction. If remission can be achieved and maintained through structured programs, health systems may gain a scalable strategy for reducing cardiovascular disease burden across diverse populations. As researchers continue to refine the optimal approaches to achieving remission, the emphasis remains on evidence-based lifestyle interventions that can be implemented in primary care and community settings.
Prediabetes awareness and prevention efforts have grown in recent years, though gaps remain. The new findings add to a body of work suggesting that reversing prediabetes is not only about preventing diabetes but also about reducing the risk of potentially life-threatening heart conditions years down the line. Health officials say the key takeaway is that prediabetes represents a window of opportunity—one that can be leveraged through sustained, real-world changes in diet and activity patterns to improve cardiovascular outcomes over the long term.
As more data emerge, researchers anticipate additional analyses that could clarify which specific components of lifestyle change—such as meal composition, timing, or intensity of physical activity—most strongly associate with remission and cardiovascular benefit. In the meantime, clinicians and patients alike are encouraged to view prediabetes as a modifiable condition with the potential for durable heart protection when addressed through evidence-based interventions and ongoing monitoring.
Public health messaging continues to emphasize early detection and risk-factor management. With nearly 100 million Americans affected or at risk, expanding access to structured lifestyle programs, nutrition counseling, and regular glucose testing could be a critical component of a comprehensive strategy to reduce not only diabetes incidence but also long-term cardiovascular disease.