Fasting blood glucose: An underestimated risk factor for cardiovascular death - Results from a 22-year follow-up of healthy nondiabetic men

OBJECTIVE - Because of the available conflicting epidemiological data, we i nvestigated the possible impact of fasting blood glucose as a risk factor f or cardiovascular death in nondiabetic men. This study reports the results from a 22-year prospective study on fasting blood glucose as a predictor of cardiovascular death. RESEARCH DESIGN AND METHODS - Of the 1,998 apparently healthy nondiabetic m en (aged 40-59 years), a total of 1,973 with fasting blood glucose <110 mg/ dl were included in the study in which also a number of conventional risk f actors were measured at baseline. RESULTS - After 22 years of follow-up, 483 men had died, 53% from cardiovas cular diseases. After dividing men into quartiles of fasting blood glucose level, it was found that men in the highest glucose quartile (fasting blood glucose >85 mg/dl) had a significantly higher mortality rate from cardiova scular diseases compared with those in the three lowest quartiles. Even aft er adjusting for age, smoking habits, serum lipids, blood pressure, forced expiratory volume in 1 s, and physical fitness (Cox model), the relative ri sk of cardiovascular death for men with fasting blood glucose >85 mg/dl rem ained 1.4 (95% CI 1.04-1.8). Noncardiovascular deaths were unrelated to fas ting blood glucose level. CONCLUSIONS - Fasting blood glucose values in. the upper normal range:appea rs to be an important independent predictor of cardiovascular death in nond iabetic apparently healthy middle-aged men.