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Prediabetes, Malignant Ventricular Hypertrophy and Stroke: The SPRINT Trial
Arnaud D Kaze1, Stephen P Juraschek2, Jordana B Cohen3
1Division of Cardiology, Department of Medicine, Banner-University Medical Center Phoenix, The University of Arizona College of Medicine, Phoenix, Arizona, USA.
Diabetes, Obesity & Metabolism
|May 11, 2026
Summary
Prediabetes and malignant left ventricular hypertrophy (LVH) significantly increase stroke risk in hypertensive adults. Combining these conditions drastically elevates cerebrovascular risk, highlighting the need for integrated risk assessment.
Area of Science:
- Cardiology
- Neurology
- Endocrinology
Background:
- Prediabetes and left ventricular hypertrophy (LVH) are prevalent risk factors in hypertensive individuals.
- The combined impact of prediabetes and malignant LVH on stroke risk remains understudied.
Purpose of the Study:
- To investigate the association between prediabetes, malignant LVH, and incident stroke in hypertensive adults.
- To determine if the coexistence of prediabetes and malignant LVH amplifies stroke risk.
Main Methods:
- Analysis of 8367 hypertensive adults from the SPRINT trial without diabetes or prior stroke.
- Prediabetes defined by fasting plasma glucose; malignant LVH by ECG criteria plus cardiac biomarkers (troponin I or NT-proBNP).
- Cox proportional hazards models used to assess stroke risk across glycemic status and malignant LVH categories.
Main Results:
- A total of 116 strokes occurred during follow-up.
- Prediabetes alone showed a trend towards increased stroke risk (HR 1.37).
- Malignant LVH alone (HR 1.94) and the combination of prediabetes with malignant LVH (HR 3.07) significantly increased stroke risk.
Conclusions:
- The coexistence of prediabetes and malignant LVH substantially elevates stroke risk in hypertensive patients.
- Integrating metabolic status (prediabetes) with cardiac biomarkers may enhance cerebrovascular risk stratification.
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