In a large community-based sample, we observed that (i) EAT thickness was correlated with 14 circulating biomarkers including NT-proBNP, as well as the dimension, wall thickness, and myocardial strain of left ventricle; (ii) thickened EAT was associated with a higher risk of incident HF and the outcome composited by myocardial infarction, ischemic stroke, HF, or death from CVD; and (iii) NT-proBNP and GLS had a mediation effect for the association between EAT thickness and HF risk. This evidence concerns the gene NPPB and hydrops fetalis.