Prediabetes Hides Heart Threats
Doctors often miss silent heart injury in prediabetes patients. This combo may drive heart failure strongly. The question stays open on how much risk it adds. This study published in the JAMA Cardiology evaluates prediabetes plus heart markers in hypertension cases carefully.
SPRINT Trial Provides Clean Data
Researchers used Systolic Blood Pressure Intervention Trial data for this post hoc study. They took two groups from 8234 adults with hypertension but no diabetes or prior heart failure. First group had baseline biomarkers only. Second group had markers at start and 12 months. Mean age reached 68 years with 37.1% women. Prediabetes meant fasting glucose 100-125 mg/dL. Heart injury used hs-cTnI ≥6 ng/L men or ≥4 ng/L women. Heart stress used NT-proBNP ≥125 pg/mL. A 25% or greater rise marked change over time.
Highest Risk Hits Double Positives
Of all participants, 39.7% had prediabetes, 35.7% showed heart injury, and 43.6% had heart stress. Median follow-up lasted 3.2 years with IQR 2.8-3.8 years. Exactly 122 people developed heart failure during tracking. Those with prediabetes plus heart injury faced HR 4.20 (95% CI 2.31-7.63) vs normal glucose without injury. Prediabetes plus heart stress showed HR 5.20 (95% CI 2.52-10.70). Single factors raised risk less than combinations did.
Rising Markers Spell Trouble
Second analysis covered 7449 participants with 12-month data. Median follow-up hit 2.3 years with IQR 1.9-2.8 years. Prediabetes with 25% hs-cTnI rise carried HR 3.05 (95% CI 1.58-5.88). Prediabetes plus NT-proBNP rise showed HR 2.39 (95% CI 1.28-4.46). Worsening biomarkers predicted heart failure clearly.
Combine Tests for Risk Scores
Hypertension clinics should check glucose plus hs-cTnI and NT-proBNP together. This spots highest-risk patients early. Prevention works best when threats show early.
Better Screening Saves Hearts
Add these biomarkers to routine hypertension care now. Risk stratification improves greatly.