Study: Prediabetes Linked to Increased Risk of Heart Disease, Death

A review from the BMJ found evidence of prediabetes being associated with an increased risk of cardiovascular disease (CVD) and death in both the general population and in patients with a history of heart problems, according to a BMJ press release.

The new findings suggest that screening and proper management of prediabetes may help to prevent CVD in otherwise healthy individuals, or primary prevention, as well as those with existing heart problems, or secondary prevention, according to the study.

Prediabetes occurs when a person's blood sugar level is higher than normal, but not high enough to be considered diabetes, according to a press release. Possible links between prediabetes and the risk of heart disease and death have become a focus of interest in recent years, although results have been inconsistent, and the term "prediabetes" remains controversial.

Researchers at the Southern Medical University in China analyzed the results of 129 studies on associations between prediabetes and the risk of CVD and death from any cause in individuals with and without a history of heart disease, involving more than 10 million individuals.

The results showed that prediabetes was associated with a 13% increased risk of all-cause mortality and a 15% increased risk of CVD over an average follow-up time of approximately 10 years in the general population, according to the press release. Additionally, a higher risk of coronary heart disease and stroke was associated with the general population.

Compared with those who have normal blood sugar levels, the data are equivalent to 7 extra deaths per 10,000 person years and almost 9 extra cases of CVD per 10,000 person years in the general study population.

In patients with a history of heart disease, prediabetes was associated with a 36% increased risk of all-cause mortality and a 37% increased risk of CVD over an average follow-up time of approximately 3 years, but no difference was seen for the risk of stroke. Compared with those who have normal blood sugar levels, the data are equivalent to 66 extra deaths per 10,000 person years and almost 190 extra cases of CVD per 10,000 person years.

Further, the researchers found that impaired glucose tolerance carried a higher risk of all-cause mortality, coronary heart disease, and stroke than impaired fasting glucose.

Although the research had several strengths, including the high quality and large size of included studies, the researchers had no access to individual participants’ data and cannot rule out the possibility that some of the observed risks may have been due to unmeasured factors.

“Prediabetes is associated with an increased risk of all-cause mortality and CVD in both the general population and patients with a history of heart disease,” the study authors said. “Screening and proper management of prediabetes “may contribute to primary and secondary prevention of CVD.”

REFERENCE

Prediabetes linked to increased risk of heart disease and death. BMJ. https://www.bmj.com/company/newsroom/prediabetes-linked-to-increased-risk-of-heart-disease-and-death/. Published July 15, 2020. Accessed July 22, 2020.