Having diabetes — especially with poor blood glucose control — is linked to faster progression to heart failure in people at high risk for the condition, according to a new study published in the Journal of the American College of Cardiology.
Heart failure is the inability of the heart to adequately pump blood to meet the body’s needs. People with both type 1 and type 2 diabetes may be at higher risk for heart failure, due in part to the harmful effects of elevated blood glucose on blood vessel health. Taking certain diabetes drugs, on the other hand, is linked to better outcomes related to heart failure — particularly SGLT2 inhibitors like Farxiga (dapagliflozin) and Jardiance (empagliflozin). Certain lifestyle factors may also improve heart failure outcomes in people with or without diabetes — even habits as simple as drinking coffee.
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For the latest study, researchers looked at 4,774 adults with what’s known as preclinical heart failure — meaning they showed an elevated risk of developing the condition based on medical tests, but hadn’t yet developed symptoms of the condition. Within this group, the researchers were interested in looking at how having diabetes and blood glucose control were related to progression to full-on heart failure. The average age of participants was about 75, and they were followed for an average of 8.6 years.
Importance of blood glucose control in early heart failure identified
During the follow-up period, there were a total of 470 new cases of heart failure. Participants who previously had what’s known as Stage B preclinical heart failure — making them more likely to develop heart failure than those with Stage A — with an A1C level (a measure of long-term blood glucose control) of 7% or higher developed heart failure at an average age of 80, compared with 83 for participants with diabetes and a lower A1C level, and 82 for participants without diabetes.
Compared with participants with Stage A preclinical heart failure and without diabetes, those with Stage B preclinical heart failure with diabetes and an A1C level of 7% or higher were 7.56 times as likely to develop heart failure during the follow-up period.
Most studies involving diabetes and heart failure have looked at people who already have full-on heart failure, the researchers noted in an article at Medscape. What makes this latest study especially valuable is that it identified the importance of blood glucose control in the very earliest stages of heart failure, before people had any symptoms or met the criteria for an actual diagnosis of the condition.
“Among older adults with preclinical [heart failure] stages, uncontrolled diabetes was associated with substantial risk of [heart failure] progression,” the researchers concluded. “Our results suggest that targeting diabetes early in the [heart failure] process is critical.”
Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,” “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Lower Your Risk of Heart Disease.”