High-blood pressure High cholesterol Cardiovaschlar diabetes cardiovaecular a large percentage of women who have had gestational diabetes will go Prediabetes cardiovascular health to develop type Cradiovascular diabetes. A new study from Healthy eating on a budget researchers found that Prediabetes cardiovascular health with blood Prediabetea levels high enough to be diagnosed with prediabetes, but not diabetes, have an increased risk of heart failure and stroke. The institutional review boards governing research in human subjects at the University of Mississippi Medical Center Jackson, MSJackson State University Jackson, MSand Tougaloo College Tougaloo, MS approved the JHS protocol, and all participants provided written informed consent at each study visit. Overview of the Jackson Heart Study: a study of cardiovascular diseases in African American men and women.

Prediabetes cardiovascular health -

To explore this further, researchers at Southern Medical University in China analysed the results of studies on associations between prediabetes and the risk of cardiovascular disease CVD and death from any cause all cause mortality in individuals with and without a history of heart disease.

The studies involved over 10 million individuals. Most were of high quality and took account of other potentially important factors, such as age, sex, ethnicity, and lifestyle. It also carried a higher risk of coronary heart disease and stroke.

In absolute terms, this equates to 7 extra deaths per 10, person years and almost 9 extra cases of cardiovascular disease per 10, person years in the general population, compared with normal blood sugar levels. In absolute terms, this equates to 66 extra deaths per 10, person years and almost extra cases of cardiovascular disease per 10, person years, compared with normal blood sugar levels.

The researchers also found that impaired glucose tolerance higher than normal blood sugar levels after eating carried a higher risk of all cause mortality, coronary heart disease and stroke than impaired fasting glucose higher than normal blood sugar levels after a period of fasting.

This analysis has several strengths, including the high quality and large size of included studies. Model 1 included adjustment for age, sex, income, and education. Model 2 included adjustment for the variables in model 1 and obesity, current smoking, physical activity, total cholesterol, HDL cholesterol, chronic kidney disease, and statin and aspirin use.

HRs for CVD events were calculated comparing participants with versus without prediabetes among those with and without hypertension, separately. Tests for interaction between prediabetes and hypertension were performed using Cox proportional hazard regression models, including the full population and main effect terms for prediabetes and hypertension and a multiplicative interaction term between hypertension and prediabetes.

In a separate analysis, we updated prediabetes and hypertension status at exams 2 and 3 i. When modeling prediabetes as a time-varying exposure, participants who developed diabetes at either exam 2 or exam 3 were censored at the first examination where they met the definition of incident diabetes.

In secondary analyses, we calculated the proportion of participants who developed diabetes at exam 2 or 3 among those without prediabetes or hypertension, with prediabetes alone, with hypertension alone, and with both prediabetes and hypertension at baseline.

We used interval-censored Weibull regression models to calculate the HRs for incident diabetes among participants with prediabetes alone, with hypertension alone, and with both prediabetes and hypertension, separately, versus those without prediabetes or hypertension Two models with progressive statistical adjustment were fitted as described above.

In addition, we calculated HRs for incident diabetes among participants with versus without prediabetes stratified by hypertension status at baseline and conducted tests for interaction between prediabetes and hypertension as described above.

Analyses were conducted using SAS 9. Participants with both prediabetes and hypertension were older, had less education, and were more likely to be obese and to be taking a statin and aspirin compared with their counterparts in the other three groups Table 1.

Baseline characteristics among JHS participants overall and with and without prediabetes stratified by hypertension status. Overall, participants had a CVD event rate 8. Without adjustment for confounders, the cumulative incidence for CVD and all-cause mortality increased progressively from participants without prediabetes or hypertension to those with prediabetes alone, with hypertension alone, and with both prediabetes and hypertension Fig.

Supplementary Figs. After multivariable adjustment, participants with prediabetes alone did not have an increased risk for the composite CVD outcome, CHD, stroke, heart failure, or all-cause mortality compared with those without prediabetes or hypertension Table 2. In contrast, participants with hypertension alone and those with both prediabetes and hypertension had a higher risk for the composite CVD outcome and CHD compared with their counterparts without prediabetes or hypertension both before and after multivariable adjustment.

Compared with participants without prediabetes or hypertension, the multivariable-adjusted HR for stroke and heart failure was 2. Cumulative incidence of CVD outcomes and all-cause mortality among JHS participants with and without prediabetes stratified by hypertension status.

Risk for cardiovascular events and all-cause mortality among JHS participants without prediabetes or hypertension, with prediabetes alone, with hypertension alone, and with both prediabetes and hypertension.

Mean follow-up for composite CVD events was Maximum follow-up for composite CVD events was CVD is defined as a composite of CHD, stroke, and heart failure events.

Model 1 includes adjustment for age, sex, income, and education. Model 2 includes adjustment for the variables in model 1 and obesity, current smoking, physical activity, total cholesterol, HDL cholesterol, chronic kidney disease, and statin and aspirin use. ref, reference.

Prediabetes was not associated with an increased risk for the composite CVD outcome, its individual components, or all-cause mortality in analyses stratified by hypertension status Supplementary Table 1.

When prediabetes and hypertension status were updated at exams 2 and 3, participants with hypertension alone or with both prediabetes and hypertension had a higher risk for CVD events compared with their counterparts without prediabetes or hypertension Supplementary Table 2.

There was no evidence that participants with prediabetes alone had an increased risk for CVD compared with their counterparts without prediabetes or hypertension.

Overall, participants developed diabetes during follow-up. The proportion of participants who developed diabetes was higher among those with both prediabetes and hypertension After multivariable adjustment, participants with prediabetes alone, hypertension alone, and both prediabetes and hypertension each had a higher risk for incident diabetes versus their counterparts without prediabetes or hypertension.

Prediabetes was associated with an increased risk for incident diabetes among participants with and without hypertension, with no evidence of effect modification by hypertension status Supplementary Table 4. Risk for incident diabetes among JHS participants with and without prediabetes cross-classified by hypertension status.

There was no evidence for an increased risk for CVD or all-cause mortality among participants with prediabetes alone compared with their counterparts without prediabetes or hypertension.

Prediabetes was associated with an increased risk for diabetes among participants with and without hypertension Supplementary Tables 7 and 8.

In the current study, there was no evidence that participants with prediabetes but not hypertension had an increased risk for CVD or all-cause mortality compared with their counterparts without prediabetes or hypertension.

However, participants with hypertension alone and with both prediabetes and hypertension had an increased risk for CVD and all-cause mortality compared with their counterparts without prediabetes or hypertension. Furthermore, when participants were stratified by hypertension status, there was no evidence of an association between prediabetes and the risk for CVD events or all-cause mortality after multivariable adjustment.

In a secondary analysis, prediabetes was associated with an increased risk for diabetes among participants with and without hypertension. An association between prediabetes and increased risk for CVD has been reported in some, but not all, studies 4 , 6 , 25 , Participants with impaired fasting glucose and impaired glucose tolerance also had a higher risk for CHD, stroke, and all-cause mortality in this meta-analysis.

In the same meta-analysis, prediabetes defined as HbA 1c between 5. In a prospective cohort study of 1, Chinese adults, the adjusted odds ratios for CVD among those with prediabetes alone and those with both prediabetes and hypertension were 1.

There was no evidence of an increased risk for CVD among participants with prediabetes alone versus those without prediabetes or hypertension HR 0. The authors concluded that the apparent association between prediabetes and CVD may be attributable to the existence of concomitant hypertension 9 , Results from the current analysis are consistent with the prior studies in China, showing an increased risk for CVD events and all-cause mortality associated with hypertension.

In the current analysis, no association was present between prediabetes and CVD or all-cause mortality among participants with and without hypertension, separately, and there was no evidence of interaction between prediabetes and hypertension. Although there was no evidence of an association between prediabetes and an increased risk for CVD in the current study, prediabetes was associated with an increased risk for diabetes among participants with and without hypertension.

Additionally, a higher proportion of participants with both prediabetes and hypertension versus those with prediabetes alone developed diabetes. This is consistent with prior studies. For example, in an analysis of , patients with a diagnosis code for prediabetes or impaired fasting glucose or impaired glucose tolerance, In the U.

Prediabetes is associated with an increased risk for diabetes, which is a well-known risk factor for CVD 21 , Because of this increased risk, black adults with prediabetes may benefit from lifestyle modification, including a heart-healthy diet and increased physical activity, which could reduce their risk for developing diabetes and CVD Hypertension is a well-established risk factor for CVD 32 , In the current study, hypertension was associated with an increased risk for CVD and all-cause mortality regardless of prediabetes status.

There are many evidence-based approaches for preventing hypertension, including losing weight among those who are overweight or obese, following a heart-healthy diet, increasing physical activity, and reducing sodium intake Additionally, antihypertensive medication is effective in reducing CVD and mortality risk among people with hypertension and prediabetes.

The current study has several strengths. The JHS enrolled a large population-based cohort of black adults. Standardized protocols were used for data collection, including BP, HbA 1c , and fasting plasma glucose. Additionally, long-term follow-up was available during which CVD events were identified and adjudicated by trained staff.

Despite these strengths, the results of the current study need to be interpreted in the context of known and potential limitations. The JHS enrolled participants at a single site in Jackson, Mississippi, and only enrolled black adults.

Furthermore, several covariates, including physical activity and cigarette smoking, were determined using self-report. There may be some misclassification in defining prediabetes and incident diabetes because of the use of only a single measurement of HbA 1c or serum glucose, lack of glucose tolerance testing, and reliance on self-reported diabetes status and glucose-lowering medication use.

In conclusion, there was no evidence in the current study of an association between prediabetes and an increased risk for CVD events or all-cause mortality, regardless of hypertension status, among black adults. In contrast, hypertension alone or concomitant with prediabetes was associated with an increased risk for CVD events and all-cause mortality.

Among black adults with prediabetes, interventions should be implemented to prevent the development of diabetes, which is a risk factor for CVD. The JHS is supported and conducted in collaboration with Jackson State University HHSNI , Tougaloo College HHSNI , the Mississippi State Department of Health HHSNI , and the University of Mississippi Medical Center HHSNI, HHSNI, and HHSNI contracts from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities.

receive support through grant 15SFRN from the American Heart Association. This work was also supported by KHL D. and RHL D. and P. The views expressed in this article are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute.

Duality of Interest. receives investigator-initiated research support unrelated to this work from Amgen, Inc. No other potential conflicts of interest relevant to this article were reported. Author Contributions. wrote the manuscript and researched the data.

is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Sign In or Create an Account.

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Biomarker-based risk prediction of incident heart failure in pre-diabetes and diabetes. JACC Heart Fail. Gong Q, Zhang P, Wang J, Ma J, An Y, Chen Y, et al.

Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: year results of the Da Qing Diabetes Prevention Outcome Study. Download references.

We thank Angela Morben, DVM, ELS, from Liwen Bianji Edanz www. Dr Jian-di Wu received financial support from the Guangdong Basic and Applied Basic Research Fund Key Project of Guangdong-Foshan Joint Fund B You can also search for this author in PubMed Google Scholar.

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Reprints and permissions. Wu, Jd. Prediabetes and risk of heart failure: the link grows stronger. Cardiovasc Diabetol 20 , Download citation. Received : 24 April Accepted : 16 May Published : 24 May Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Download ePub. Commentary Open access Published: 24 May Prediabetes and risk of heart failure: the link grows stronger Jian-di Wu ORCID: orcid.

Abstract In a recently published paper in Cardiovascular Diabetology , Sinha et al. Availability of data and materials Not applicable. Abbreviations ADA: American Diabetes Association FPG: Fasting plasma glucose HbA1c: Hemoglobin A1c IFG: Impaired fasting glucose IGT: Impaired glucose tolerance T2DM: Type 2 diabetes mellitus.

Cardiovascuular is Greek yogurt for diabetics life-long condition where your body cardivascular not produce enough insulin Type 1 cardiovascylar your cardilvascular cannot Prediabetez Prediabetes cardiovascular health insulin it Prediabetes cardiovascular health effectively Type 2. Prediabetes cardiovascular health body uses insulin to break down and control how much sugar is in your blood. Sugar glucose is a major source of energy for the cells in your tissue, muscles, heart and brain. If your body is unable to break down the sugar it needs for energy, you will have too much glucose and that can damage organs and blood vessels. Diabetes increases the risk of high blood pressure, narrowing of the arteries atherosclerosiscoronary artery disease and stroke. Prediabetes cardiovascular health adults diagnosed Prediavetes prediabetes may be more likely to be hospitalized for heart attacks Prediagetes their peers with normal blood sugar Prediabetes cardiovascular health, according to preliminary new research. Prediabetes occurs when a person's blood sugar levels are higher than normal but not high enough for a diagnosis of Type 2 diabetes. About 88 million U. adults have prediabetes, 29 million of whom are under 45 years old. Akhil Jain said in a news release.