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Uncontrolled diabetes can accelerate heart failure by 3 years

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By JOHNS HOPKINS MEDICINE

Uncontrolled diabetes may significantly raise the risk of heart failure progression in older adults with early-stage, or preclinical, heart failure, according to recent research conducted by Johns Hopkins. Researchers discovered that managing diabetes at an early stage in the development of heart failure has a significant potential to stop the development of overt or later-stage heart failure.

The research was recently released in the Journal of the American College of Cardiology.

The Atherosclerosis Risk in Communities (ARIC) Study, an ongoing investigation supported by the National Institutes of Health that examines the medical effects of plaque accumulation on artery walls, provided the research team with its data. More than 4,700 ARIC participants were chosen, and clinical information collected at the most recent study visit was analyzed for each of them.

Preclinical heart failure, as defined by the American Heart Association and the American College of Cardiology, was present in all patients, which meant they were either in stage A or stage B of the condition. Stage A is defined as the presence of at least one clinical risk factor for heart failure, such as obesity or hypertension, but no structural heart disease. In stage B, structural heart disease or increased cardiac biomarkers are present but there are no heart failure symptoms or signs.

The findings showed that uncontrolled diabetes was associated with the advancement of heart failure for participants in stages A and B of heart failure. Participants with uncontrolled diabetes in stage A were 1.5 times more likely to progress to overt heart failure, while those in stage B were 1.8 times more likely. Additionally, among participants in stage B, those with uncontrolled diabetes experienced overt heart failure at a younger age (80 years) than their counterparts with controlled diabetes (83 years) or no diabetes (82 years).

“Our results demonstrate the vulnerability of older adults with co-occurring diabetes and stage A or B heart failure,” says Justin Echouffo Tcheugui, M.D., Ph.D., the study’s first author and an associate professor of medicine at the Johns Hopkins University School of Medicine. “We believe that such people may greatly benefit from preventive therapies including lifestyle modification and medication. There are three to four times more individuals with preclinical heart failure than with overt heart failure; many lives can be prolonged by addressing diabetes in those early stages.”

The research team has plans to continue studying this issue and determine why diabetes has this effect on patients with preclinical heart failure.

“We know that diabetes and heart failure are highly prevalent and strongly interrelated,” says Echouffo Tcheugui, “But as far as we know, this is the first study to assess their relationship through this specific lens. We want to continue exploring that relationship.”

Reference: “Diabetes and Progression of Heart Failure: The Atherosclerosis Risk In Communities (ARIC) Study” by Justin B. Echouffo-Tcheugui, Chiadi E. Ndumele, Sui Zhang, Roberta Florido, Kunihiro Matsushita, Josef Coresh, Hicham Skali, Amil M. Shah and Elizabeth Selvin, 14 June 2022, Journal of the American College of Cardiology.
DOI: 10.1016/j.jacc.2022.03.378

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