{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T23:48:33Z","timestamp":1793490513333,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23 HL153774"],"award-info":[{"award-number":["K23 HL153774"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Prediabetes and left ventricular hypertrophy (LVH) are common risk factors in adults with hypertension. Whether their coexistence, particularly in the presence of subclinical myocardial injury or stress (malignant LVH), confers a heightened stroke risk is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>We analysed 8367 hypertensive adults without diabetes or prior stroke (mean age: 68\u2009\u00b1\u20099.4\u2009years, 36.8% women, 39.8% with prediabetes) from the Systolic Blood Pressure Intervention Trial (SPRINT). Prediabetes was defined as fasting plasma glucose 100\u2013125\u2009mg\/dL. Malignant LVH was defined as electrocardiographic LVH (Cornell voltage product &gt;\u20092436\u2009mm\u00b7ms) with elevated high\u2010sensitivity cardiac troponin I (\u2265\u20096\u2009ng\/L in men, \u2265\u20094\u2009ng\/L in women) or N\u2010terminal pro\u2013B\u2010type natriuretic peptide (\u2265\u2009125\u2009pg\/mL). The primary outcome was incident stroke. Cox proportional hazards models estimated hazard ratios (HRs) across categories of glycemic status and malignant LVH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow\u2010up of 3.3\u2009years, 116 participants developed stroke. Compared with normoglycemic individuals without malignant LVH, adjusted HRs for stroke were 1.37 (95% CI, 0.88\u20132.12) for prediabetes alone, 1.94 (95% CI, 1.06\u20133.53) for malignant LVH alone, and 3.07 (95% CI, 1.66\u20135.70) for both prediabetes and malignant LVH. The stroke risk was also elevated for prediabetes combined with LVH plus myocardial injury (HR, 3.71; 95% CI, 2.00\u20136.88) or myocardial stress (HR, 2.84; 95% CI, 1.44\u20135.58). Results were consistent using alternate LVH definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among hypertensive adults, the coexistence of prediabetes and malignant LVH substantially increased stroke risk. Integrating metabolic status with cardiac biomarkers may improve cerebrovascular risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70858","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T03:10:13Z","timestamp":1778555413000},"page":"6725-6734","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prediabetes, Malignant Ventricular Hypertrophy and Stroke: The\n                    <scp>SPRINT<\/scp>\n                    Trial"],"prefix":"10.1111","volume":"28","author":[{"given":"Arnaud D.","family":"Kaze","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Banner\u2010University Medical Center Phoenix, The University of Arizona College of Medicine  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P.","family":"Juraschek","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Medicine Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordana B.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division, Perelman School of Medicine, and Department of Biostatistics, Epidemiology, and Informatics Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Banner\u2010University Medical Center Phoenix, The University of Arizona College of Medicine  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiadi E.","family":"Ndumele","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie M.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Research and Center for Cardiometabolic Disease Prevention, Department of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarrett D.","family":"Berry","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Texas at Tyler School of Medicine  Tyler Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8460-1617","authenticated-orcid":false,"given":"Justin B.","family":"Echouffo\u2010Tcheugui","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, Diabetes &amp; Metabolism Johns Hopkins School of Medicine  Baltimore Maryland USA"},{"name":"Welch Prevention Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University  Baltimore Maryland 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