From the Cardiovascular Health Branch, National Center for Chronic
Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta, Ga (W.H.G., J.B.C.), and the Division of Neurosciences
Critical Care, the Johns Hopkins Hospital, Baltimore, Md (A.I.Q.).
Correspondence to Wayne H. Giles, MD, MS, Cardiovascular Health Branch, CDC, 4770 Buford Hwy, MS K-47, Atlanta, GA 30341. E-mail HWG0{at}CDC.GOV
Background and
Purpose—Although diabetes mellitus (DM) is known to increase the
risk of cardiovascular disease (CVD), the effect of
impaired glucose tolerance (IGT) on the risk remains unclear. We
determined whether IGT was associated with an increased likelihood for
stroke and myocardial infarction in a nationally
representative sample of US adults.
Methods—We evaluated the association between IGT (defined as a
fasting glucose level of <140 mg/dL and a plasma glucose level of
between 140 and 200 mg/dL 2 hours after administration of 75 grams of
an oral glucose load) and DM (defined as the current use of insulin or
an oral hypoglycemic medication, a fasting plasma glucose level of
>140 mg/dL, or a plasma glucose level of >200 mg/dL 2 hours after
administration of an oral glucose load) with a self-reported physician
diagnosis of stroke and myocardial infarction in 6547 adults aged 40 to
74 years participating in the Third National Health and Nutrition
Examination Survey. Multivariate logistic regression
analyses were used to investigate these relationships.
Results—IGT and DM were observed in 1494 and 1532 adults,
respectively. After adjustment for differences in age, gender,
race/ethnicity, education, hypertension, cholesterol, body
mass index, and cigarette smoking, IGT was not associated with stroke
(odds ratio [OR], 0.9; 95% confidence interval [CI], 0.5 to 1.6)
or myocardial infarction (OR, 1.1; 95% CI, 0.7 to 1.6). DM was
associated with both stroke (OR, 1.6; 95% CI, 1.0 to 2.6) and
myocardial infarction (OR, 1.9; 95% CI, 1.3 to 2.8).
Conclusions—In contrast to DM, IGT was not associated with an
increased likelihood of prevalent nonfatal stroke or myocardial
infarction.
© 1998 American Heart Association, Inc.
Original Contributions
Impaired Glucose Tolerance and the Likelihood of Nonfatal Stroke and Myocardial Infarction
The Third National Health and Nutrition Examination Survey
Key Words: diabetes mellitus • glucose tolerance • myocardial infarction • stroke
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