Association of HbA1c with prevalent cardiovascular disease in the original cohort of the Framingham Heart Study

• Published in: Diabetes (New York, N.Y.) Vol. 41; no. 2; pp. 202 - 208
• Main Authors: Singer, D.E, Nathan, D.M, Anderson, K.M, Wilson, P.W.F, Evans, J.C
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.02.1992
• Subjects: Aged; Aged, 80 and over; Associated diseases and complications; Biological and medical sciences; blood glucose; body mass index; body weight; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; cholesterol; Cohort Studies; Confounding Factors (Epidemiology); Diabetes; Diabetes mellitus; Diabetes. Impaired glucose tolerance; disease surveys; drugs; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; gender differences; Glycated Hemoglobin A - metabolism; hemoglobin; high density lipoprotein; Humans; Hyperglycemia; Hyperglycemia - blood; Hyperglycemia - complications; hypertension; Logistic Models; longitudinal studies; Male; Medical sciences; men; Physiological aspects; Prevalence; Risk Factors; Sex Factors; smoking (habit); women; Massachusetts; Endocrinopathy; Human; Diabetes mellitus; Cardiovascular disease; Glucose; Hemoglobin A1; Coronary heart disease; Arterial disease; Vascular disease; Chronic; Hyperglycemia; Risk factor; Complication; Measurement method; Macroangiopathy; Glycemia
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/diab.41.2.202

We studied the cross-sectional relationship between HbA1c and cardiovascular disease (CVD) in the survivors of the original cohort of the Framingham Heart Study (n = 1045). HbA1c was significantly related to prevalent CVD among women but not men. HbA1c was also related to hypertension and to the ratio of total to high-density lipoprotein cholesterol levels. In regression analyses that controlled for these and other potential risk factors, HbA1c remained significantly related to CVD among women. The relative odds of CVD increased 1.39-fold (95% confidence interval 1.06-1.83) for increases in HbA1c of 1% (e.g., for HbA1c from 5 to 6%). The relationship was not weakened when known diabetic subjects or subjects taking beta-blocker or thiazide medications were excluded from analysis. In contrast, there was no significant relationship between "casual" blood glucose and prevalent CVD. Our results reveal a strong, significant, independent association between hyperglycemia, measured by HbA1c, and CVD among older women.