Prediabetes, Malignant Left Ventricular Hypertrophy, and Risk of Incident Heart Failure Among Hypertensive Adults.
Prediabetes with malignant left ventricular hypertrophy linked to much higher heart failure risk
Prediabetes, Malignant Left Ventricular Hypertrophy, and Risk of Incident Heart Failure Among Hypertensive Adults.
Prediabetes is common among adults with hypertension, but its contribution to heart failure (heart failure) risk, particularly in the presence of subclinical myocardial abnormalities, remains uncertain.
The objective of the study was to assess whether prediabetes combined with malignant left ventricular hypertrophy (left ventricular hypertrophy)-defined as left ventricular hypertrophy accompanied by subclinical myocardial injury or stress-is associated with increased heart failure risk in hypertensive adults without diabetes.
This prospective cohort analysis included 8,131 hypertensive adults without diabetes or prior heart failure from the SPRINT (Systolic Blood Pressure Intervention Trial).
prediabetes plus malignant left ventricular hypertrophy more than triples heart failure risk
During a median 3.3-year follow-up, 115 heart failure events occurred.
Similar patterns were observed for prediabetes with left ventricular hypertrophy plus myocardial injury (HR: 4.02; 95% CI: 2.21-7.30) or stress (HR: 4.04; 95% CI: 2.22-7.34).
Prediabetes alone was not associated with heart failure (adjusted HR: 1.24; 95% CI: 0.80-1.91).
Among hypertensive adults, the coexistence of prediabetes and malignant left ventricular hypertrophy identifies a subgroup at substantially elevated heart failure risk.
Integrating glycemic status, ECG findings, and cardiac biomarkers may enhance heart failure risk stratification and inform preventive strategies.