R. Antonicelli et al., Random fasting hyperglycemia as cardiovascular risk factor in the elderly:A 6-year longitudinal study, CLIN CARD, 24(4), 2001, pp. 341-344
A large body of evidence suggests that diabetes increases the risk of coron
ary heart disease (CHD), but whether fasting hyperglycemia is associated wi
th a major risk for CHD is still under debate. The aim of the present study
was to investigate the role played by fasting hyperglycemia in the develop
ment of cardiovascular disease (CVD) in an elderly population when associat
ed with common risk factors for CVD (i.e., hypertension, hypercholesterolem
ia, smoking, etc). We analyzed a sample of 455 subjects aged greater than o
r equal to 60 years. The risk factors taken into account were systolic and
diastolic blood pressure levels, use of antihypertensive drugs, total serum
cholesterol, serum triglycerides, and smoking habit. Glycemia was measured
at entry on a fasting sample. During the follow-up period (mean 6 years),
the occurrence of CVD was monitored (criteria for the occurrence of CVD inc
luded total cardiovascular mortality, fatal or nonfatal myocardial infarcti
on, symptomatic coronary heart disease [stable and unstable angina], the ne
ed for percutaneous transluminal coronary angioplasty or coronary artery by
pass graft, fatal or nonfatal stroke, and transient ischemic attack). A tot
al of 427 subjects completed the follow-up. During this period, 73 subjects
(17.10%) developed CVD according to the above criteria. A Cox proportional
hazard model was designed to evaluate the contribution of variables in pre
dicting CVD. Relative risks and 95% confidence intervals for CVD were calcu
lated from the regression coefficients to study the association between the
risk of developing CVD and predicting variables. We found a relation betwe
en occurrence of CVD and fasting hyperglycemia: subjects with fasting glyce
mia, > 126 mg/dl at enrollment, but without previous clinical diagnosis of
diabetes, showed a 2.01 times higher risk than those with fasting glycemia
< 126 mg/dl. Hence, random fasting hyperglycemia can predict the occurrence
of CVD in elderly subjects.