What is the relationship between HbA1c and the risk of developing heart failure in patients with diabetes mellitus?
Multiple studies have shown a correlation between higher HbA1c levels and an increased risk of developing heart failure in patients with diabetes mellitus. A large cohort study of nearly 50,000 diabetic patients found that each 1% increase in HbA1c was associated with an 8% increased risk of heart failure. The ARIC study found that the adjusted HR of HF for individuals without coronary heart disease at baseline was 1.20 (95% CI, 1.04 1.40) for those with coronary heart disease at baseline. The CHS (Cardiovascular Health Study) also found that elevated fasting glucose among older adults with diabetes mellitus was independently associated with incident HF. Despite this evidence, randomized, controlled clinical trials of more intensive glucose control have not demonstrated a benefit in HF reduction with intensive glycemic control.