Cardiovascular events and mortality in people with and without type 2 diabetes: An observational study in a contemporary multi-ethnic population.

<div>Aims</div><div>Examine ethnicity‐specific associations between type 2 diabetes (T2DM) and risk of a cardiovascular disease (CVD) event as well as risk of specific CVD phenotypes in England.</div><div><br></div><div>Methods</div><div>We obtained data from the Clinical Practice Research Datalink for adults with and without T2DM diagnosed 2000‐2006. The outcome was the first CVD event during 2007‐2017 and components: aortic aneurysm, cerebrovascular accidents, heart failure, myocardial infarction, peripheral vascular disease, and other CVD‐related conditions. Flexible parametric survival models were used to estimate ethnicity‐specific adjusted hazard ratios (aHR).</div><div><br></div><div>Results</div><div>734,543 people with and without T2DM (29,847; 4.1%) were included; most were of White ethnicity (93.0% with and 92.3% without T2DM) followed by South Asian (3.2% and 4.6%). During a median follow‐up of 11.0 years, 67,218 events occurred (6,156 in individuals with T2DM). T2DM was associated with a small increase in CVD events (aHR: 1.06; 95% CI: 1.02, 1.09) in individuals of White ethnicity; while the aHR was considerably higher in South Asians (1.28; 1.09, 1.51), primarily due to an increased risk of myocardial infarction (1.53; 1.08, 2.18).</div><div><br></div><div>Conclusions</div><div>Despite universal access to healthcare, there are large disparities in CVD outcomes in people with and without T2DM. Other, non‐traditional risk factors may play a role in the higher CVD risk associated with T2DM in South Asians.</div>