Elevated HbA1c level: a risk factor for cardiovascular disease mortality in patients with chronic heart failure?

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 approximately 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.