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Issue 91 Item 5 PPBG in Non Diabetic Patients can Predict Cardiovascular Events

Using the 2 hour Postprandial blood glucose can help predict which patients are at greater risk of strokes and MI. Dr. Nicholas L. Smith, from the University of Washington, Seattle, and associates collected data on 4014 community-dwelling adults, 65 years of age or older, who participated in the Cardiovascular Health Study. At baseline these subjects had no treated diabetes and no history of MI or stroke.

What they found and reported on Feb 06 was that compared with fasting glucose levels alone, the 2-hour postchallenge glucose level is better at identifying older patients who are at risk of major cardiovascular events.

During a median 8.5 years of followup there were 764 cardiovascular events, including 359 MIs, 348 cases of incident cerebrovascular disease, and 117 deaths from CAD (60 subjects had both cerebrovascular disease and CAD), according to the report in the January 28th issue of the Archives of Internal Medicine.

In adjusted analysis, the researchers found that fasting glucose levels of 115 mg/dL or more were linked with an increased risk for cardiovascular events (hazard ratio 1.66), relative to levels less than 115 mg/dL.,
Analysis of 2-hour postchallenge glucose levels adjusted for age, sex, and race revealed that for every 10 mg/dL increase in level there was a 2% increase in the risk of a cardiovascular event (ie, hazard ratio 1.02). At a 2-hour glucose level of 154 mg/dL or more the hazard ratio for incident cardiovascular events was 1.29, Dr. Smith’s team notes.

In combined analysis of both fasting and 2-hour glucose levels, only the latter remained predictive of cardiovascular events, the investigators add.

They conclude that "although a 2-hour measure of glycemia is burdensome in routine clinical practice, it may serve a role in identifying older adults at increased risk of incident cardiovascular events." Arch Intern Med 2002