Heart failure & cardiomyopathiesSecondary analysis
Prediabetes, Subclinical Myocardial Injury or Stress, and Heart Failure Risk for Adults With Hypertension
- Post hoc analysis of the SPRINT randomised trial (prospective cohort)
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
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
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident HF with prediabetes and ≥25% increase in biomarker over 12 months (longitudinal analysis) · median 2.3 years — Prediabetes and hs-cTnI increase vs Normoglycemia, no myocardial injury · hs-cTnI | 3.05 (1.58–5.88) | |
| Incident HF with prediabetes and ≥25% increase in biomarker over 12 months (longitudinal analysis) · median 2.3 years — Prediabetes and NT-proBNP increase vs Normoglycemia, no myocardial injury · NT-proBNP | 2.39 (1.28–4.46) | |
| 0.20.5125Hazard ratio (log scale) |
- 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
Summarised from the published abstract; every number is checked against it