The predictive role of blood glucose for mortality in subjects with cardiovascular disease.
Using the Framingham Heart Study data (United States, 1948-1978), the authors examined the association of blood glucose with 2-year all-cause, cardiovascular, and noncardiovascular mortality in subjects with documented cardiovascular disease. After adjustment for systolic blood pressure, cholesterol, body mass index, cigarette smoking, and use of antihypertensive agents, they found that glucose was a strong, independent predictor of mortality. However, the relations for men and women were qualitatively different. For men, adjusted mortality risk increased very rapidly through the normal range (from 4.12% at 3.89 mmol/liter (70 mg/dl) to 12.26% at 5.55 mmol/liter (100 mg/dl)) and was flat at 12.26% thereafter. For women, risk was flat at 3.65% through the normal range and then increased rapidly, reaching 8.34% at 6.99 mmol/liter (126 mg/d), but increased much more slowly thereafter. Exactly analogous relations held for cardiovascular mortality. For men and women combined, noncardiovascular mortality increased from 1.82% at 3.89 mmol/liter to 2.06% at 5.55 mmol/liter to 2.29% at 6.99 mmol/liter (p for trend = 0.009). These findings suggest that although 5.55 mmol/liter (normal) may be a useful mortality risk division (albeit with different implications for the two sexes), 6.99 mmol/liter (diabetic) is not, especially for men.
Port
Sidney C
SC
Department of Mathematics, University of California-Los Angeles, Los Angeles, CA 90095-1555, USA. sport@ucla.edu
Boyle
Noel G
NG
Hsueh
Willa A
WA
Quiñones
Manuel J
MJ
Jennrich
Robert I
RI
Goodarzi
Mark O
MO
D000368:Aged; D001786:Blood Glucose; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors
D001786:Blood Glucose