Elevated HbA_1c level: a risk factor for cardiovascular disease mortality in patients with chronic heart failure?

Abstract

This Practice Point commentary discusses a study by Gerstein et al. that found an independent relationship between HbA_1c level and the risk of cardiovascular mortality, death from any cause, or worsening heart failure in patients with chronic heart failure. The magnitude of this risk increased by ∼10–20% per 1% increase in HbA_1c level. These findings add to a growing body of evidence that HbA_1c levels predict cardiovascular disease mortality and morbidity in individuals with low, medium and high risks of cardiovascular disease. However, further research will be required to establish whether lowering HbA_1c levels to <7% reduces the risk of cardiovascular events. Nevertheless, measurement of HbA_1c level could identify and target effective therapies to individuals who are at high risk of cardiovascular disease. Improved understanding of the role of glycemic control in the development of cardiovascular disease might indicate new interventions for treatment and prevention.