Issue 158 Item 8 Glucose, Cholesterol Interact & Raises Heart Disease Risk in Hy

Elevated glucose and cholesterol levels work together to magnify the risk of coronary heart disease (CHD) in hypertensive patients. Elevated total cholesterol levels (> 200 mg/dL) were associated with an increased risk of CHD, but the effect was only slight in the absence of increased glucose levels (> 110 mg/dL).

High levels of glucose and cholesterol have both been identified as independent risk factors for CHD. However, it was unclear if an adverse synergistic interaction existed between them.

To investigate, Dr. Hillel W. Cohen and colleagues, from the Albert Einstein College of Medicine in New York, analyzed data from 6672 hypertensive patients enrolled in a worksite treatment program. At entry, the subjects had a fasting glucose level < 126 mg/dL and total cholesterol level < 260 mg/dL. The follow-up period averaged 5.6 years. The effects of glucose and cholesterol were synergistic. For example, a total cholesterol level of 200 to 219 mg/dL increased the risk of CHD by 25% in patients with normal glucose levels. With an elevated glucose level, a 2.7-fold increased risk of CHD was seen. “Our findings suggest that using glucose status to modify criteria for cholesterol interventions might improve CHD outcomes,” the authors state. “In light of the rapidly rising prevalence of the metabolic syndrome, our findings, if confirmed, could have important clinical implications for cholesterol guidelines for CHD prevention among hypertensive patients.” Hypertension 2004;43:983-987. =============================== FACT: People who consume one to three drinks per day have a 33% to 56% lower risk for type 2 diabetes. Moderate alcohol consumption has more benefits that previously believed. Moderate alcohol intake may be beneficial, but excessive alcohol increases the risk of developing diabetes. More than 3 drinks a day increased the risk of diabetes by 43%. Ann Intern Med. 2004; 140:211-219.