Fasting plasma glucose and incident heart failure risk: a population-based cohort study and new meta-analysis

Hassan Khan, Setor K Kunutsor, Jussi Kauhanen, Sudhir Kurl, Eiran Z Gorodeski, Amanda I Adler, Javed Butler, Jari A Laukkanen

Research output: Contribution to journalArticle (Academic Journal)peer-review

11 Citations (Scopus)


BACKGROUND: There remains uncertainty regarding the association between fasting plasma glucose (FPG) and risk of heart failure (HF) in individuals without a history of diabetes.

METHODS AND RESULTS: We assessed the association between FPG and HF risk in a population-based cohort of 1,740 men aged 42-61 years who were free from HF or diabetes at baseline. During a mean follow-up of 20.4 years, 146 participants developed HF. In age-adjusted analysis, the hazard ratio (HR) for HF per 1 mmol/L increase in FPG was 1.34 (95% confidence interval 1.22-1.48). This association persisted after adjusting for established HF risk factors: HR 1.27, 95% confidence interval 1.14-1.42. The findings remained consistent across several clinical subgroups and in analyses excluding incident coronary heart disease or diabetes during follow-up. In a meta-analysis of 10 prospective studies involving 4,213 incident HF cases, the HR for HF per 1 mmol/L increase in FPG level was 1.11 (95% confidence interval 1.04-1.17), with evidence of heterogeneity between studies (I(2) = 79%; 95% confidence interval 63%-89%; P < .001). The corresponding HR was 1.12 (95% confidence interval 1.08-1.18) on exclusion of the single study that accounted for the heterogeneity.

CONCLUSIONS: There exists a positive, continuous, and independent association between FPG and risk for HF. Studies are warranted to evaluate the causal relevance of these findings.

Original languageEnglish
Pages (from-to)584-92
Number of pages9
JournalJournal of Cardiac Failure
Issue number8
Publication statusPublished - Aug 2014


  • Blood Glucose
  • Fasting
  • Follow-Up Studies
  • Global Health
  • Heart Failure
  • Humans
  • Incidence
  • Population Surveillance
  • Risk Assessment
  • Risk Factors

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