The Kailuan study was a prospective cohort study con-ducted in Tangshan City, China from 2006 to 2017.Its purpose was to identify the association between prediabetes and incident myocardial infarction with in a large general population including persons with and without hypertension. A secondary anal. described the association of prediabetes with incident diabetes.The study population included 8500 participants drawn from a population of 85000-nearly half of whom had prediabetes. Participants met criteria for hypertension and/or hyperglycemia, had an average age of 58 years, and nearly half (47%) had either hypertension or prediabetes, and 11% had both prediabetes and hypertension, Participants were classified in to four categories: 1, normal controls; 2, hypertension alone; 3, hyperglycemia alone; and 4, both hypertension and hyper-glycemia.All were free of prevalent cardiovascular disease (CVD) at entry. Participants were interviewed at 2-yr intervals.During 11 years of follow-up, there were some 1122 (1.9%) myocardial infarctions. Outcomes were compared after controlling for relevant contributing factors. Myocardial infarction incidence did not differ between those with hyperglycemia alone, and normal controls. By contrast, those with hyperglycemia and hypertension, or hyperten-sion alone, both experienced significantly increased incidence of myocardial infarction compared with controls.As both hyperglycemia and hypertension increase inflammation, it is not surprising that C-reactive protein levels were elevated in both. Those with prediabetes or hypertension alone as well as those with both, had significantly increased incidence of diabetes-from-1-4% beyond that of normal controls.These finding are consistent with general experience that uncomplicated prediabetes has little of any immediate impact on cardiovascular disease outcomes, but does speed the transition to diabetes. This progression is not only both the principle adverse effect of prediabetes but also suggests an unexplored opportunity for intervention to prevent cardiovascular events.