The reason why coexistence of pre-DM and HTN, but not pre-DM without HTN, leads to higher CVD events might reflect the fact that both of them induce endothelial dysfunction and inflammation through elevation of inflammatory factors such as tumor necrosis factor α (TNF α) and intercellular adhesion molecule-1 (ICMA-1) [27]. Here, TNF is linked to endothelial dysfunction.