Prediabetes, Subclinical Myocardial Injury or Stress, and Heart Failure Risk for Adults With Hypertension

Is prediabetes associated with the risk of heart failure (HF) among adults with hypertension with subclinical myocardial injury or stress, as assessed by baseline and longitudinal cardiac biomarkers?In this cohort study of 8234 adults with hypertension without diabetes enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT), prediabetes combined with elevated or increasing high-sensitivity troponin I or N-terminal pro–B-type natriuretic peptide was associated with higher HF risk. The greatest risk occurred among individuals with both prediabetes and subclinical myocardial injury or stress.These findings suggest that coexisting prediabetes and subclinical myocardial injury or stress are associated with a high-risk group for incident HF, supporting integration of glycemic status with cardiac biomarkers for prevention.

Corresponding Author: Justin B. Echouffo-Tcheugui, MD, PhD, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, 5501 Bayview Cir, Baltimore, MD 21224 (jechouf1@jhmi.edu).

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