For a study, researchers sought to identify the role of diabetes in the development of preclinical heart failure (HF) stages to overt HF that is not understood well.

Visit 5 of the ARIC (Atherosclerosis Risk In Communities) research comprised 4,774 persons with preclinical HF (stage A [n=1,551] or B [n=3,223]) in (2011-2013). Within each stage (A or B), they looked at the relationships between diabetes and glycemic control (hemoglobin A1C [HbA1C]<7% versus ≥7%) with HF progression, as well as the connections of HF stage (A vs. B), diabetes, and glycemic control with incident HF.

During the 8.6 years of follow-up, there were 470 HF episodes among the participants (mean age 75.4 years, 58% women, 20% Black). Participants in stage B with HbA1C ≥7% had clinical HF at a younger age than those with managed diabetes or without diabetes (mean age 80 years vs. 83 years vs. 82 years; P<0.001). When compared to stage A (HR: 1.52; 95% CI: 0.53-4.38), HbA1C ≥7% was more substantially linked with HF in stage B (HR: 1.83; 95% CI: 1.33-2.51). Participants with stage B and HbA1C ≥7% exhibited a higher risk of HF development compared to stage A without diabetes (HR: 7.56; 95% CI: 4.68-12.20) in cross-categories of preclinical HF stage and HbA1C .

Uncontrolled diabetes was related to a significant risk of HF development in older persons with preclinical HF stages. The findings indicated that treating diabetes early in the HF process is crucial.

Reference: jacc.org/doi/10.1016/j.jacc.2022.03.378