Glucose tolerance and mortality from ischemic heart disease in an elderly population. Impact of repeated glucose measurements

Abstract

The impact of glucose tolerance, measured repeatedly, on the mortality from ischemic heart disease (IHD) was assessed in a cohort of 202 elderly patients, aged 64 to 84 years in 1971, from a general practice. During the period from 1971 to 1975 the participants were examined annually. The area under the glucose tolerance curve (AUC) was used as a summary index, and for every subject the mean AUC over the 5-year period was calculated. This index was most strongly correlated with the mean 60-minute glucose level (r = 0.96). Between 1975 and 1987, 125 participants died, 28.8% of whom died from IHD. No association between a single measurement of glucose tolerance and IHD mortality was observed. However, using the mean AUC over the 5-year period, a positive association was observed, independent of age, sex, and other potential confounders (P = 0.04). These results indicate that glucose tolerance independently predicts mortality from coronary heart disease in an elderly cohort, provided that information on repeated measurements is taken into account. A continuous risk gradient is suggested.