The Prevalence of Cardiovascular Disease in Adults with Type 2 Diabetes in China: Results from the Cross-Sectional CAPTURE Study

Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of death in Chinese adults with type 2 diabetes (T2D), and treatment guidelines have increasingly focused on the comprehensive management of T2D and CVD. Here, we report data from the Chinese population within the CAPTURE study, including CVD prevalence in patients with T2D and insights into their management.

Methods: CAPTURE (a multinational, non-interventional, cross-sectional study in adults with T2D) included data from eight centers in China from July to September 2019. Overall CVD prevalence estimates were calculated, and descriptive data regarding CVD subtypes and treatment were collected and reported here.

Results: Of 805 adults with T2D enrolled in China (61.9% male, median age 59 years), 273 had established CVD, with an estimated prevalence (95% CI) of 33.9% (30.6%, 37.3%). Most CVD cases were atherosclerotic (94.9%). Coronary heart disease had the highest estimated prevalence (16.0%), followed by carotid artery disease (9.6%) and cerebrovascular disease (7.7%). Use of glucose-lowering agents (GLAs) with proven cardiovascular benefits (glucagon-like peptide-1 receptor agonists and/or sodium-glucose cotransporter-2 inhibitors) was low in the China sample (7.7%). Approximately half of the CVD subgroup in the China sample was receiving cardiovascular medication, but use of guideline-directed agents was low (e.g., statins: 35.9%; angiotensin II receptor blockers: 15%; angiotensin-converting enzyme inhibitors: 2.6%).

Conclusions: In the Chinese CAPTURE population, one-third of patients had established CVD, with atherosclerotic CVD largely accounting for the CVD burden; use of GLAs with proven cardiovascular benefits and cardiovascular medications was low, suggesting an unmet need for optimal management in this group.

Keywords: Cardiovascular diseases; China; Cross-sectional studies; Prevalence; Type 2 diabetes mellitus.

Fig. 1

Prevalence of CVD in people with T2D by CVD subtype and diagnoses in China in 2019. Data are overall prevalence estimates (95% CI). Diagnoses are not mutually exclusive, and one participant may have multiple diagnoses. ^†Categorized as ASCVD. ^‡Included conduction abnormalities. ASCVD atherosclerotic cardiovascular disease, AV atrioventricular, CHD coronary heart disease, CI confidence interval, CVD cardiovascular disease, PAD peripheral artery disease, SND sinus node dysfunction, T2D type 2 diabetes

Fig. 2

Use of GLAs with proven CV risk reduction in the CAPTURE population stratified by CVD status in China in 2019. Data are proportion of participants using a GLA with proven CV risk reduction per ADA guidelines (GLP-1 RAs: dulaglutide, liraglutide and semaglutide; SGLT2 inhibitors: canagliflozin, dapagliflozin and empagliflozin). ADA American Diabetes Association, ASCVD atherosclerotic cardiovascular disease, CV cardiovascular, CVD cardiovascular disease, GLA glucose-lowering agent, GLP-1 RA glucagon-like peptide-1 receptor agonist, SGLT2 sodium-glucose co-transporter-2