These efforts include the treatment and prevention of coronary artery disease and adequate treatment of hypertension in patients with dia- betes mellitus. An important risk factor for the development of HF in patients with diabetes mellitus is abnormal glucose con- In a large cohort study of nearly 50000 dia- betic patients without HF at baseline, each 1% increase in HbA1c was associated with an 8% increased risk of In a similar study of patients with diabetes mellitus enrolled in the ARIC study, the adjusted HR of HF for for individuals without coronary heart disease at baseline and 1.20 (95% CI, 1.04 1.40) for those with coronary heart disease at baseline.119 The increased risk for the development of HF with increasing HbA1c in ARIC was also present in patients in the absence of incident coro- In the CHS (Cardiovascular Health Study), elevated fasting glucose among older adults with diabetes mellitus was also independently associated with incident HF.121 Despite the epidemiological data linking worse gly- cemic control to greater rates of HF in observational studies and clinical trials, data from randomized, con- trolled, clinical trials of more intensive glucose control have not demonstrated a benefit in HF reduction with intensive glycemic control. 