(Circulation. 1995;91:2591-2595.)
© 1995 American Heart Association, Inc.
Articles |
Sudden Death, Impaired Glucose Tolerance, and Diabetes in Japanese American Men
From the John A. Burns School of Medicine, Department of Medicine, Divisions of Clinical Epidemiology and Geriatric Medicine (J.D.C., B.L.R.) and the Department of Family Practice and Community Health (J.D.C.), University of Hawaii, Manoa; the Honolulu Heart Program, Kuakini Medical Center (J.D.C., B.L.R., D.C., K.Y.); NHLBI, Honolulu (C.M.B.); and the Division of Biostatistics, University of Virginia School of Medicine, Charlottesville (R.D.A.).
Correspondence to J. David Curb, MD, John A. Burns School of Medicine, Division of Geriatric Medicine, University of Hawaii, 347 N Kuakini St, HPM-9, Honolulu, HI 96817.
Background Diabetes and glucose intolerance have been shown to increase the risk of cardiovascular mortality in a number of different populations. Most studies have been based on short follow-up periods, and few have had sufficient numbers to allow researchers to look at sudden death as an outcome.
Methods and Results The relation of sudden death, defined as
unexpected death occurring within either 1 or 24 hours of first
symptoms, to glucose intolerance measured by a nonfasting 1-hour
postload measurement made in 1965 or history of diabetes was examined
by use of 23 years of follow-up on the 8006 participants enrolled in
the Honolulu Heart Program. After adjustment for baseline body mass
index, hypertension, cholesterol, triglycerides, smoking, alcohol
consumption, and left ventricular hypertrophy or strain, the relative
risks for sudden death within 24 hours in individuals with high-normal
(151 to 224 mg/dL), asymptomatic high glucose values (
225 mg/dL), and
diabetes compared with those with lower glucose values (<151 mg/dL)
were 1.59, 2.22, and 2.76, respectively. All these relative risks were
statistically significant (P
.05). Trends for sudden death
in 1 hour were similar. Among men with sudden death <1 hour after
onset of symptoms, the strength of the association between diabetes and
sudden death was stronger among those classified as having died of
unknown causes who thus were more likely to have died of an arrhythmia
than among those classified as having died of coronary heart
disease.
Conclusions The relations seen in these analyses indicate that individuals with glucose intolerance or diagnosed diabetes are at increased risk for sudden death.
Key Words: death, sudden • glucose • diabetes mellitus
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