High A1C Tied to Heart Failure in Those Without Diabetes

Higher risk of incident heart failure seen with A1C of 5.5 to 6.4 percent versus 5.0 to 5.4 percent

MONDAY, Aug. 23 (HealthDay News) -- Among middle-aged people without diabetes, elevated hemoglobin A1C is associated with risk of later heart failure, indicating that chronic hyperglycemia even before diabetes development may be a risk factor for heart failure, according to research published in the August issue of Diabetes.

Kunihiro Matsushita, M.D., of the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues analyzed data from 11,057 middle-aged and older participants in the Atherosclerosis Risk in Communities Study who, at baseline, were free of heart failure or diabetes and aged 45 to 64 years.

The researchers noted 841 cases of incident heart failure hospitalization or death over a median of 14.1 years of follow-up. Risk of incident heart failure was higher in those with an A1C of 6.0 to 6.4 percent (hazard ratio, 1.40) or 5.5 to 6 percent (hazard ratio, 1.16) compared to the reference group of 5.0 to 5.4 percent, after adjustment for fasting glucose and other factors. However, higher fasting glucose was not linked to heart failure after adjusting for factors including A1C.

"In conclusion, elevated A1C (≥5.5 to 6.0 percent) was more strongly associated with increased risk of heart failure as compared with fasting glucose in a middle-aged bi-ethnic population without diabetes. Our findings suggest that chronic hyperglycemia even before the development of diabetes is an independent risk factor of heart failure and may contribute to the development of heart failure beyond its effect on CHD risk," the authors conclude.

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