Is prediabetes associated with an increased risk of heart disease?

This analysis looked at whether prediabetes affects heart health or overall survival. It found that people with prediabetes have higher rates of heart attack, stroke, and mortality.

Prediabetes is a condition in which the body’s ability to handle glucose (sugar) is worse than normal. Over time, roughly 70% of prediabetes cases develop into full-blown diabetes, which includes high glucose levels in the blood. Glucose can damage blood vessels over time, leading fatty plaques to build up inside the arteries. Patients with diabetes have a higher risk of heart attack, stroke, and other types of cardiovascular disease. It is not clear whether prediabetes also increases the risk of heart disease.

This study analyzed the results of 129 studies on prediabetes and heart disease. It included overall 10,069,955 people with prediabetes. 

97 studies looked at the general population of people with prediabetes. These studies included 9,972,629 people who were followed for 9.8 years on average. People with prediabetes had a 16% higher risk of heart disease and a 14% higher risk of stroke. They also had a 13% higher risk of mortality.

There are several ways to define prediabetes. It may be based on blood glucose after fasting overnight, how high blood glucose rises after eating, or glucose control over the previous two months (HbA1c test). Poor glucose tolerance, or a high rise in blood sugar after eating, showed the strongest connection to cardiovascular disease (23% increased risk).

32 studies specifically followed people with both prediabetes and hardening of the arteries (atherosclerosis). These studies included 97,326 patients who were followed for 3.2 years on average. For these patients, prediabetes was related to a 37% higher risk of cardiovascular disease.

This study found that people with prediabetes have a higher risk of heart disease. This risk was even higher for people who already had hardening of the arteries.

During follow-up, patients with prediabetes may have developed full diabetes.

Talk to your doctor about diet, exercise, and medication to manage your prediabetes.