Blood Glucose and Its Link to Heart and Blood Vessel Disease in Women

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Kayana AM, Herrington D, Vittinghoff E, et al.: Impaired fasting glucose and cardiovascular outcomes in postmenopausal women with coronary artery disease. Ann Intern Med 142:813–820, 2005.

What is the problem and what is known about it so far?

People with type 2 diabetes are more likely to get cardiovascular disease (disease of the heart and blood vessels). People with abnormal fasting glucose levels (a condition in which the body does not handle blood glucose properly) are more likely to get diabetes and may also have a greater chance of getting heart and blood vessel disease.

In 2003, the American Diabetes Association changed the definition of abnormal fasting glucose from 110 mg/dl or more to 100 mg/dl or more in order to better identify people at risk of getting diabetes.

Why did the researchers do this particular study?

Researchers wanted to study the link between a person's blood glucose level and its effect on their heart and blood vessels.

Researchers wanted to see which level of blood glucose is better at predicting if a person is going to have problems like heart failure or stroke.

Who was studied?

The study included 2,763 women who had been through menopause from 20 U.S. medical centers. All participants had heart and blood vessel disease and were taking part in the Heart and Estrogen/progestin Replacement Study (HERS).

How was the study done?

Participants completed survey questions about their health. Each woman had a physical exam and blood tests. Researchers tracked heart and blood vessel problems, including heart attack, stroke, TIA (transient ischemic attack, or "mini-stroke"), and heart failure. Participants were followed for almost 7 years.

What did the researchers find?

Women with diabetes were 75% more likely to have heart and blood vessel problems than those with a normal blood glucose level. Women with blood glucose in the 110-125 mg/dl range were 37% more likely to have a heart attack.

Women with a blood glucose level of 100 mg/dl or lower had no increased risk of stroke, mini-stroke, or heart failure.

What were the limitations of the study?

Because the study included only women, the findings may not apply to men. Women who already had heart and blood vessel disease were studied, so it's not know whether abnormal blood glucose levels increase risk in women who have not had heart or blood vessel problems.

What are the implications of the study?

If other researchers confirm the findings, it might help identify people at greater risk of heart and blood vessel disease who need more medical attention.