Glucose tolerance and coronary heart disease: Helsinki Policemen Study

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Abstract

The relationship of glucose tolerance to the prevalence of symptoms and ECG signs of coronary heart disease (CHD), and to the 10-yr mortality from all causes, cardiovascular diseases and CHD was investigated in 867 Helsinki policemen aged 40–59 on whom an oral glucose tolerance test was carried out in 1966–1967. An oral glucose load of 75 or 90 g according to body surface area was used and blood glucose was determined fasting, 1 and 2 hr after the glucose load.

Fasting and post-load blood glucose levels did not show any definite relationship to the prevalence of CHD symptoms (angina pectoris, history of verified myocardial infarction, non-verified severe chest pain attack) at the time of the initial examination, but these blood glucose variables showed a trend to a positive association to the prevalence of ischaemic ECG abnormalities. In multivariate analyses including age, systolic blood pressure, plasma cholesterol, body mass index and smoking, the blood glucose variables, however, failed to show a significant independent relationship to the prevalence of ECG abnormalities.

In univariate analyses, a positive non-linear relationship was found between the blood glucose variables and the 10-yr mortality from all causes, cardiovascular diseases and CHD. The mortality rates were significantly higher in the top quintiles or deciles of 1-hr and 2-hr post-load blood glucose levels than in the corresponding combined lower quantiles. Fasting blood glucose showed similar trends, though these were not statistically significant. In multivariate analyses including age, systolic blood pressure, plasma cholesterol, body mass index and smoking, the blood glucose variables, however, did not show a significant independent contribution in the prediction of the 10-yr mortality from all causes, cardiovascular diseases or CHD.

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    Present address: Department of Medicine, University of Kuopio, Kuopio, Finland.

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