Heart failure & cardiomyopathies

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

JAMA CardiolPublished Post hoc analysis of the SPRINT randomised trial

Authors' conclusion

These findings suggest that among adults with hypertension, prediabetes in combination with subclinical myocardial injury or stress is associated with a significantly elevated risk for HF.

Study context

Population
Adults with hypertension without DM or prior heart failure (HF) (SPRINT)122 developed HF
Participants
8,234 adults
Comparison
Joint categories of prediabetes and subclinical myocardial injury or stress vs normoglycemia without biomarker elevation
Primary endpoint
Adjudicated incident HF
Follow-up
Median 3.2 years
Methodological detailsprospective cohort
  • Prospective cohort

Primary result

As reported in the abstract

Incident HF · median 3.2 years
Each group vs normoglycemia, no myocardial injuryHazard ratio (95% CI)
Prediabetes and injuryhighest HF risk
4.20(2.31–7.63)
Prediabetes and stressmyocardial stress
5.20(2.52–10.70)

Further findings

Incident HF with prediabetes and ≥25% increase in biomarker over 12 months (longitudinal analysis) · median 2.3 years

HR (95% CI)
Prediabetes and hs-cTnI increasehs-cTnI3.05 (1.58–5.88)
Prediabetes and NT-proBNP increaseNT-proBNP2.39 (1.28–4.46)
  • Incident HF with prediabetes and ≥25% increase in biomarker over 12 months (longitudinal analysis): 7449 participants in longitudinal analysis

Original publication

Prediabetes, Subclinical Myocardial Injury or Stress, and Heart Failure Risk for Adults With Hypertension. JAMA Cardiol. Published 1 March 2026. doi:10.1001/jamacardio.2025.4927

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