Abnormal Blood Glucose and Coronary Heart Disease: The Puerto Rico Heart Health Program

The presence of abnormal blood glucose (ABG) was determined for participants in the Puerto Rico Heart Health Program, a prospective epidemiological study of cardiovascular disease. Subjects were considered to have ABG at baseline if they were receiving treatment for diabetes (diet, oral hypoglycemics, or insulin), or if the blood glucose level was 140 mg/dl or more. Urban-rural comparisons of the prevalence of ABG were made in this cohort of 2585 rural and 6208 urban men aged 45–64 yr. The prevalence of ABG in the urban population was more than double that in the rural. This population has been followed up for coronary heart disease (CHD) over an 8¼-yr period. ABG at baseline is significantly associated with CHD death in urban men. When the relationship is controlled for smoking, systolic blood pressure, cholesterol, and relative weight, the relationship remains significant. The association with total CHD is similar. Either by adjusting for diabetes (i.e., when treated diabetes was excluded from analysis) or by entering both blood glucose and diabetes under treatment into the model, blood glucose was no longer statistically significant. This suggests that ABG, rather than blood glucose alone, is the important variable associated with CHD.