PURPOSE OF REVIEW: Prediabetes, or dysglycemia in the absence of diabetes, is a prevalent condition typically defined by a glycated hemoglobin (HgbA1c) of 5.7- < 6.5%. This article reviews current contemporary data examining the association between prediabetes and cardiovascular disease (CVD) as well as HgbA1c as a continuous measure of cardiovascular risk across the glycemic spectrum. RECENT FINDINGS: Dysglycemia in the prediabetic range is associated with an increased risk of both subclinical and clinical CVD, including atherosclerotic CVD, chronic kidney disease, and heart failure. Several recent large, prospective studies demonstrate roughly linear risk with increasing HgbA1c, even below the threshold for prediabetes. "High-risk" patients with prediabetes have similar CVD risk as those with diabetes. HgbA1c below the threshold for diabetes stratifies CVD risk. Use of HgbA1c as a continuous measure, rather than simply dichotomized, may inform current and future prevention strategies. Given the high population attributable risk associated with prediabetes, targeted prevention strategies in this population warrant dedicated study.
Cardiovascular Diseases , Diabetes Mellitus , Prediabetic State , Blood Glucose , Cardiovascular Diseases/etiology , Diabetes Mellitus/epidemiology , Glycated Hemoglobin/analysis , Heart Disease Risk Factors , Humans , Prediabetic State/complications , Prediabetic State/epidemiology , Prospective Studies , Risk Factors
Anticholesteremic Agents/therapeutic use , Ezetimibe/therapeutic use , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypercholesterolemia/drug therapy , PCSK9 Inhibitors/therapeutic use , Practice Patterns, Physicians'/statistics & numerical data , Adult , Cholesterol, LDL/blood , Disease Management , Female , Guideline Adherence , Humans , Hypercholesterolemia/blood , Male , Practice Guidelines as Topic , Registries , Severity of Illness Index , Sex Factors , Young Adult