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Abnormal blood glucose and coronary heart disease: the Puerto Rico Heart Health Program
Insights
Abnormal blood glucose (ABG), defined by treatment or high levels, was more prevalent in urban than rural men. ABG at baseline significantly predicted coronary heart disease (CHD) death in urban men, independent of other risk factors.
Area of Science:
- Epidemiology
- Cardiovascular Disease Research
- Metabolic Health Studies
Background:
- The Puerto Rico Heart Health Program is a prospective epidemiological study investigating cardiovascular disease.
- Abnormal blood glucose (ABG) is a critical health indicator with potential links to heart health.
- Understanding the prevalence and impact of ABG in different populations is crucial for public health.
Purpose of the Study:
- To compare the prevalence of abnormal blood glucose (ABG) between urban and rural populations in Puerto Rico.
- To determine the association between baseline ABG and the incidence of coronary heart disease (CHD) over an 8.25-year follow-up period.
- To investigate whether ABG or blood glucose levels alone are more significantly associated with CHD.
Main Methods:
- A cohort of 2585 rural and 6208 urban men aged 45-64 years was analyzed.
- ABG was defined as receiving diabetes treatment or having a blood glucose level ≥140 mg/dl at baseline.
- Coronary heart disease (CHD) incidence was tracked over 8.25 years, with statistical adjustments for smoking, blood pressure, cholesterol, and relative weight.
Main Results:
- The prevalence of ABG was more than double in the urban population compared to the rural population.
- Baseline ABG was significantly associated with CHD death in urban men, even after controlling for major cardiovascular risk factors.
- The association with total CHD was similar to CHD death.
- When analyses accounted for diabetes treatment, blood glucose levels alone were not statistically significant predictors of CHD.
Conclusions:
- Abnormal blood glucose (ABG), encompassing treated diabetes and high glucose levels, is a significant predictor of coronary heart disease (CHD) in urban men.
- The prevalence of ABG differs substantially between urban and rural settings.
- ABG, rather than isolated blood glucose measurements, appears to be the key variable linked to increased CHD risk in this cohort.
Abstract:
The presence of abnormal blood glucose (ABG) was determined for participants in the Puerto Rico Heart Health Program, a prospective epidemiological study of cardiovascular disease. Subjects were considered to have ABG at baseline if they were receiving treatment for diabetes (diet, oral hypoglycemics, or insulin), or if the blood glucose level was 140 mg/dl or more. Urban-rural comparisons of the prevalence of ABG were made in this cohort of 2585 rural and 6208 urban men aged 45-64 yr. The prevalence of ABG in the urban population was more than double that in the rural. This population has been followed up for coronary heart disease (CHD) over an 8 1/4-yr period. ABG at baseline is significantly associated with CHD death in urban men. When the relationship is controlled for smoking, systolic blood pressure, cholesterol, and relative weight, the relationship remains significant. The association with total CHD is similar. Either by adjusting for diabetes (i.e., when treated diabetes was excluded from analysis) or by entering both blood glucose and diabetes under treatment into the model, blood glucose was no longer statistically significant. This suggests that ABG, rather than blood glucose alone, is the important variable associated with CHD.