Heart failure is a serious condition in which the heart cannot pump blood as well as it should. This makes it harder for the body to receive the oxygen and nutrients it needs. Over time, heart failure can lead to fatigue, shortness of breath, swelling in the legs, and many other health problems.
Doctors have long known that high blood pressure and diabetes increase the risk of heart failure. However, new research suggests that another hidden factor may also play an important role.
A study led by researchers at Johns Hopkins Medicine has found that signs of silent heart damage or stress in the blood may strongly increase the risk of heart failure in people who already have high blood pressure and prediabetes.
The researchers say these warning signs can appear long before a person develops symptoms of heart disease. The findings were published in the medical journal JAMA Cardiology.
Prediabetes is a condition in which blood sugar levels are higher than normal but not high enough to be called diabetes. It is often considered an early stage of diabetes. Many people with prediabetes feel completely healthy and may not realize they have it.
However, the condition can still affect the body in important ways. According to recent estimates, more than 115 million adults in the United States are living with prediabetes.
Doctors already know that prediabetes is linked to a higher risk of heart disease, kidney problems, and nerve damage. But the research team wanted to understand whether hidden signs of heart injury or stress could further increase the chances of heart failure among these individuals.
To explore this question, the scientists analyzed health data from a large clinical study known as the Systolic Blood Pressure Intervention Trial, or SPRINT. This major study began in 2010 and was designed to examine how controlling blood pressure affects important organs such as the heart, kidneys, and brain.
For the new analysis, the researchers examined information from 8,234 adults who had high blood pressure but did not have diagnosed diabetes. The participants were all at least 50 years old, and their average age was 68. About 63 percent of the participants were men and about 37 percent were women.
The scientists looked at blood test results that can reveal early signs of heart injury or heart stress. These tests measure substances in the blood that are released when the heart muscle is under strain or has experienced small amounts of damage.
One marker, called high-sensitivity cardiac troponin I, can show tiny amounts of heart muscle injury that would not cause symptoms. Another marker, called NT-proBNP, reflects stress on the heart when it has to work harder to pump blood.
The researchers also identified which participants had prediabetes based on their fasting blood sugar levels. Prediabetes was defined as a fasting blood glucose level between 100 and 125 milligrams per deciliter.
At the start of the study, nearly 40 percent of the participants had prediabetes. More than one third showed signs of silent heart injury, and nearly 44 percent had markers of heart stress.
The scientists then followed the participants for a median period of about 3.2 years to see who eventually developed heart failure.
The results revealed a striking pattern. People who had both prediabetes and signs of hidden heart injury or heart stress were about ten times more likely to develop heart failure compared with people who had neither condition. In contrast, individuals without prediabetes but with signs of heart injury or stress had a smaller increase in risk.
The researchers also examined how changes in the blood markers over time affected heart failure risk. If levels of the heart injury or stress markers increased by at least 25 percent after one year, the risk of heart failure rose significantly. This pattern appeared in both groups, but the increase in risk was stronger among people with prediabetes.
Interestingly, prediabetes by itself was not strongly linked to heart failure risk. Instead, the combination of prediabetes and silent heart damage appeared to be the most dangerous situation.
The researchers believe this may happen because metabolic changes in people with prediabetes make the heart more vulnerable to damage. Even small amounts of stress or injury to the heart muscle could therefore lead to larger problems over time.
These findings may have important implications for preventive care. Because the warning signs can be detected with simple blood tests, doctors may be able to identify high-risk patients much earlier. This could allow healthcare providers to begin treatments or lifestyle changes before heart failure develops.
The study suggests that people with prediabetes should not automatically be considered low risk if they feel healthy. Hidden heart stress may already be present, and routine testing could help reveal these early warning signals.
However, the research also has some limitations. The study followed participants for only a few years, so longer studies are needed to confirm the long-term risk patterns. In addition, the participants already had high blood pressure, which means the results may not apply to every population.
Even with these limitations, the study provides valuable insight into how heart disease may develop silently over time. The findings suggest that combining information about blood sugar levels and heart injury biomarkers could help doctors better identify patients who are most likely to develop heart failure.
Overall, the research highlights the importance of early detection. By identifying hidden heart damage in people with prediabetes, doctors may be able to intervene earlier, reduce risk, and prevent serious heart problems before they begin.
If you care about heart disease, please read studies that herbal supplements could harm your heart rhythm, and how eating eggs can help reduce heart disease risk.
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