Relationship of glucose tolerance to prevalence of ECG abnormalities and to 5-year mortality from cardiovascular disease: Findings of the Chicago Heart Association Detection Project in Industry

Abstract

Among the 40,000 employed men and women screened in Chicago industry, 7841 white men age 40–59 formed the cohort studied to determine significance of asymptomatic hyperglycemia for coronary disease. In cross-sectional analysis of frequency of ECG abnormalities, those in the upper $\text{2}\text{1}\text{2}\text{\%}$ of the glucose distribution had higher rates of such abnormalities than the rest of the group, and men in the highest quintile likewise had higher rates of ECG abnormalities than were seen in the lowest quintile. Analysis of these data using the multiple logistic showed inconsistent positive association of glucose with prevalence of ECG abnormalities defined by the Whitehall and Pooling Project criteria, but no association with definite MI, on ECG.

In 5-yr mortality follow-up, while men with overt diabetes experienced coronary death rates 2–3 times higher than those without such a diagnosis, similar univariate analysis that excluded diagnosed diabetics showed no association between glucose level and coronary mortality. In multivariate analysis as well, no association between initial glucose and subsequent coronary or cardiovascular mortality was seen, although all causes mortality rates were significantly related to glucose levels. The inconsistent results between univariate and multivariate analyses, as well as between cross-sectional and prospective findings, do not support a conclusion that asymptomatic hyperglycemia is a major coronary risk factor.