Abstract
In the Whitehall study of 18 403 male civil servants aged 40-64 years the 10 year mortality rates from coronary heart disease and stroke showed a non-linear relation to two hour blood glucose values, with a significantly increased risk for glucose intolerant subjects with concentrations above the 95th centile point (5.4-11.0 mmol/l; 96-199 mg/100 ml) and for diabetics (blood glucose greater than or equal to 11.1 mmol/l; greater than or equal to 200 mg/100 ml). Multiple logistic analysis showed that between one half and three quarters of the relative risks for deaths from coronary heart disease and stroke were "unexplained" by between group differences in risk factors such as age, blood pressure, obesity, smoking, cholesterol concentration, and electrocardiographic abnormalities. Within the glucose intolerant and diabetic groups the risk factors most strongly related to subsequent death from coronary heart disease were age and blood pressure, with less consistent relations for smoking, cholesterol concentration, and obesity. This study confirms the importance of hypertension as a cardiovascular risk factor in groups with glucose intolerance and diabetes, and this may have important preventive implications.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Fuller J. H., Elford J., Goldblatt P., Adelstein A. M. Diabetes mortality: new light on an underestimated public health problem. Diabetologia. 1983 May;24(5):336–341. doi: 10.1007/BF00251820. [DOI] [PubMed] [Google Scholar]
- Fuller J. H., McCartney P., Jarrett R. J., Keen H., Rose G., Shipley M. J., Hamilton P. J. Hyperglycaemia and coronary heart disease: the Whitehall study. J Chronic Dis. 1979;32(11-12):721–728. doi: 10.1016/0021-9681(79)90051-1. [DOI] [PubMed] [Google Scholar]
- Fuller J. H., Shipley M. J., Rose G., Jarrett R. J., Keen H. Coronary-heart-disease risk and impaired glucose tolerance. The Whitehall study. Lancet. 1980 Jun 28;1(8183):1373–1376. doi: 10.1016/s0140-6736(80)92651-3. [DOI] [PubMed] [Google Scholar]
- Garcia M. J., McNamara P. M., Gordon T., Kannel W. B. Morbidity and mortality in diabetics in the Framingham population. Sixteen year follow-up study. Diabetes. 1974 Feb;23(2):105–111. doi: 10.2337/diab.23.2.105. [DOI] [PubMed] [Google Scholar]
- Jarrett R. J., McCartney P., Keen H. The Bedford survey: ten year mortality rates in newly diagnosed diabetics, borderline diabetics and normoglycaemic controls and risk indices for coronary heart disease in borderline diabetics. Diabetologia. 1982 Feb;22(2):79–84. doi: 10.1007/BF00254833. [DOI] [PubMed] [Google Scholar]
- Jarrett R. J., Shipley M. J., Rose G. Weight and mortality in the Whitehall Study. Br Med J (Clin Res Ed) 1982 Aug 21;285(6341):535–537. doi: 10.1136/bmj.285.6341.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kannel W. B., McGee D. L. Diabetes and cardiovascular risk factors: the Framingham study. Circulation. 1979 Jan;59(1):8–13. doi: 10.1161/01.cir.59.1.8. [DOI] [PubMed] [Google Scholar]
- Kannel W. B., Wolf P. A., Verter J., McNamara P. M. Epidemiologic assessment of the role of blood pressure in stroke. The Framingham study. JAMA. 1970 Oct 12;214(2):301–310. [PubMed] [Google Scholar]
- Knowler W. C., Bennett P. H., Ballintine E. J. Increased incidence of retinopathy in diabetics with elevated blood pressure. A six-year follow-up study in Pima Indians. N Engl J Med. 1980 Mar 20;302(12):645–650. doi: 10.1056/NEJM198003203021201. [DOI] [PubMed] [Google Scholar]
- Paffenbarger R. S., Jr, Wing A. L. Characteristics in youth predisposing to fatal stroke in later years. Lancet. 1967 Apr 8;1(7493):753–754. doi: 10.1016/s0140-6736(67)91367-0. [DOI] [PubMed] [Google Scholar]
- Pyörälä K., Savolainen E., Lehtovirta E., Punsar S., Siltanen P. Glucose tolerance and coronary heart disease: Helsinki policemen study. J Chronic Dis. 1979;32(11-12):729–745. doi: 10.1016/0021-9681(79)90052-3. [DOI] [PubMed] [Google Scholar]
- Reid D. D., Brett G. Z., Hamilton P. J., Jarrett R. J., Keen H., Rose G. Cardiorespiratory disease and diabetes among middle-aged male Civil Servants. A study of screening and intervention. Lancet. 1974 Mar 23;1(7856):469–473. doi: 10.1016/s0140-6736(74)92783-4. [DOI] [PubMed] [Google Scholar]
- Rhoads G. G., Kagan A. The relation of coronary disease, stroke, and mortality to weight in youth and in middle age. Lancet. 1983 Mar 5;1(8323):492–495. doi: 10.1016/s0140-6736(83)92189-x. [DOI] [PubMed] [Google Scholar]
- Sasaki A., Kamado K., Horiuchi N. A changing pattern of causes of death in Japanese diabetics. Observations over fifteen years. J Chronic Dis. 1978;31(6-7):433–444. doi: 10.1016/0021-9681(78)90007-3. [DOI] [PubMed] [Google Scholar]
- Shenfield G. M., Elton R. A., Bhalla I. P., Duncan L. J. Diabetic mortality in Edinburgh. Diabete Metab. 1979 Jun;5(2):149–158. [PubMed] [Google Scholar]
- Walker S. H., Duncan D. B. Estimation of the probability of an event as a function of several independent variables. Biometrika. 1967 Jun;54(1):167–179. [PubMed] [Google Scholar]
- Yano K., Kagan A., McGee D., Rhoads G. G. Glucose intolerance and nine-year mortality in Japanese men in Hawaii. Am J Med. 1982 Jan;72(1):71–80. doi: 10.1016/0002-9343(82)90580-0. [DOI] [PubMed] [Google Scholar]