Johns Hopkins Study Finds Tenfold Heart Failure Risk for Adults Combining Prediabetes with Subclinical Cardiac Stress Biomarkers

Johns Hopkins researchers find adults with prediabetes and high cardiac biomarkers are 10 times more likely to suffer heart failure. Learn the screening signs.

By: AXL Media

Published: Mar 9, 2026, 11:53 AM EDT

Source: The information in this article was sourced from EurekAlert!

Identifying a High Risk Metabolic Subpopulation

A new collaborative study funded by the National Institutes of Health has uncovered a massive disparity in heart failure risk among adults previously considered to be in an intermediate stage of disease. Researchers at the Johns Hopkins University School of Medicine found that while prediabetes is a known risk factor, its combination with asymptomatic heart injury or stress creates a uniquely dangerous clinical profile. Published in JAMA Cardiology on January 14, the findings suggest that over 115 million Americans currently living with prediabetes may harbor hidden cardiovascular vulnerabilities. According to senior author Dr. Justin Basile Echouffo Tcheugui, the study aimed to determine if subclinical markers could pinpoint which individuals are most likely to progress toward a formal heart failure diagnosis.

Leveraging Historical Clinical Trial Data

To reach these conclusions, the research team performed a secondary analysis of the Systolic Blood Pressure Intervention Trial, a landmark study involving over 8,200 participants aged 50 and older. The team focused specifically on patients who had high blood pressure but lacked a formal diagnosis of diabetes at the start of the trial. By comparing baseline cardiac biomarkers against health outcomes over a median follow up of 3.2 years, the scientists were able to calculate precise hazard ratios for various combinations of metabolic and cardiac stress. According to the data, this retrospective look at thousands of patients provided a robust foundation for identifying how common, asymptomatic complications drive long term heart failure risks.

The Tenfold Surge in Cardiac Vulnerability

The most striking revelation of the study was the sheer magnitude of risk for patients exhibiting both prediabetes and elevated biomarkers of heart injury. Specifically, those with baseline prediabetes and high levels of troponin I or NT-proBNP were overall 10 times more likely to experience heart failure compared to those with healthy levels. In contrast, participants who had the same cardiac stress markers but lacked prediabetes saw a much more moderate risk increase of approximately three to four times. According to the statistical models used by the researchers, this indicates that underlying metabolic abnormalities in prediabetic patients may significantly exacerbate the dam...