A recent study from researchers at Johns Hopkins Medicine has uncovered significant evidence linking elevated blood biomarkers associated with subclinical heart injury or stress to an increased risk of heart failure (HF) in adults who have both prediabetes and hypertension. This research, funded by the National Institutes of Health (NIH) and published in the *JAMA Cardiology* journal, emphasizes the importance of identifying at-risk individuals through routine blood tests to facilitate preventive care before heart failure occurs.
Prediabetes, characterized by blood sugar levels that are higher than normal but not high enough to be classified as diabetes, affects an estimated 115.2 million adults in the U.S. As of January 2026. This condition is widely recognized as a precursor to various health complications, including heart, kidney, and nerve damage. According to Dr. Justin Basile Echouffo Tcheugui, the study’s senior author and an associate professor of medicine at Johns Hopkins University, the objective was to explore whether additional factors such as subclinical heart injury or stress could further elevate the risk of developing heart failure beyond the risks posed by prediabetes alone.
The study analyzed data from participants of the NIH Systolic Blood Pressure Intervention Trial (SPRINT), which initially sought to assess how blood pressure reduction in adults with hypertension impacts heart, kidney, and brain health. The researchers examined clinical data from 8,234 participants aged 50 and older, who did not have a formal diabetes diagnosis. They focused on biomarkers indicative of heart injury or stress, specifically measuring high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP).
Key Findings from the Study
The analysis revealed that 39.7% of the participants had prediabetes, 35.7% showed signs of subclinical heart injury, and 43.6% exhibited subclinical heart stress at the study’s onset. Over a median follow-up period of 3.2 years, participants with both prediabetes and either subclinical heart injury or stress were ten times more likely to experience heart failure compared to those without prediabetes. In contrast, individuals without prediabetes but with heart injury or stress experienced a moderate increase in heart failure risk, with hazard ratios of 3.28 and 3.78, respectively.
those with prediabetes who showed a 25% or greater increase in hs-cTnI or NT-proBNP levels at their 12-month follow-up were found to be 3.05 times and 2.39 times more likely to develop heart failure, respectively. Surprisingly, prediabetes alone did not correlate with an increase or decrease in heart failure risk, indicating that the combination of metabolic abnormalities associated with prediabetes may exacerbate cardiovascular issues.
Implications for Clinical Practice
Dr. Echouffo Tcheugui emphasizes the potential for clinicians to identify prediabetic patients at heightened risk for heart failure through blood tests, enabling timely medical interventions. “Using heart failure biomarkers, we can identify and treat these patients who have a much higher risk of cardiovascular disease,” he stated. This proactive approach could significantly improve patient outcomes by preventing cardiac events before they happen.
The findings of this study highlight the necessitate to focus on the prediabetes state, which is often overlooked in clinical settings. By recognizing and defining these vulnerable populations, healthcare providers can implement preventive measures to safeguard patient health.
What Lies Ahead
As the healthcare community continues to grapple with the rising prevalence of prediabetes and related cardiovascular risks, this study underscores the importance of routine screening and the potential for targeted interventions. Ongoing research is essential to further understand the relationship between metabolic conditions and heart health, ensuring that effective strategies are developed to manage and mitigate these risks.
For those interested in heart health, it is crucial to engage with healthcare providers about screening options, especially if you have risk factors like hypertension or prediabetes. This dialogue can lead to earlier identification and improved management of potential heart issues.
This article is for informational purposes only and is not intended as medical advice. Always consult a healthcare professional for medical concerns.
