Journal Article

The Predictive Role of Blood Glucose for Mortality in Subjects with Cardiovascular Disease

Sidney C. Port, Noel G. Boyle, Willa A. Hsueh, Manuel J. Quiñones, Robert I. Jennrich and Mark O. Goodarzi

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 163, issue 4, pages 342-351
Published in print February 2006 | ISSN: 0002-9262
Published online December 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwj027
The Predictive Role of Blood Glucose for Mortality in Subjects with Cardiovascular Disease

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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.

Keywords: blood glucose; cardiovascular diseases; mortality; risk factors; AIC, Akaike's Information Criterion; CVD, cardiovascular disease

Journal Article.  5072 words.  Illustrated.

Subjects: Public Health and Epidemiology

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