Asymptomatic hyperglycemia and atherosclerotic vascular disease in the elderly

• Published in: Diabetes care Vol. 15; no. 8; pp. 1020 - 1030
• Main Authors: Mykkänen, L, Laakso, M, Pyörälä, K
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.08.1992
• Subjects: Aged; Analysis of Variance; Arteriosclerosis - complications; Arteriosclerosis - diagnosis; Associated diseases and complications; Biological and medical sciences; Blood Glucose - analysis; Cerebrovascular Disorders - epidemiology; Coronary Disease - complications; Coronary Disease - diagnosis; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - epidemiology; Electrocardiography; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Glucose Tolerance Test; Humans; Hyperglycemia - complications; Hyperglycemia - diagnosis; Intermittent Claudication - epidemiology; Male; Medical Records; Medical sciences; Prevalence; Regression Analysis; Risk Factors; Sex Characteristics; Endocrinopathy; Human; Concomitant disease; Hyperglycemia; Prevalence; Atherosclerosis; Cardiovascular disease; Asymptomatic; Impaired glucose tolerance; Elderly
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.15.8.1020

Asymptomatic hyperglycemia and atherosclerotic vascular disease in the elderly. L Mykkänen , M Laakso and K Pyörälä Department of Medicine, University of Kuopio, Finland. Abstract OBJECTIVE--To investigate the relationship between asymptomatic hyperglycemia (IGT or newly diagnosed NIDDM) and atherosclerotic vascular disease. RESEARCH DESIGN AND METHODS--A representative cross-sectional population sample of 1431 subjects (511 men, 920 women; 65-74 yr old). Altogether, 312 men and 515 women had NGT, 84 men and 158 women had IGT, 33 men and 59 women had newly diagnosed NIDDM, and 82 men and 188 women had previously diagnosed NIDDM. Participation rate was 71%. Main outcome measures were prevalence rates of CHD, stroke, and intermittent claudication. RESULTS--There was no difference in the prevalence of definite or possible MI verified at hospital between subjects with asymptomatic hyperglycemia and NGT (15.5 vs. 13.3% in men, 6.3 vs. 5.3% in women). Men with asymptomatic hyperglycemia had 1.5 x higher prevalence of angina pectoris (29.4 vs. 19.3%, P less than 0.05), major Q-QS changes (21.1 vs. 12.0%, P less than 0.05), ischemic ECG changes (59 vs. 45%, P less than 0.05), and silent MI on ECG (14.8 vs. 7.9%, P less than 0.05) compared to men with NGT. Women with asymptomatic hyperglycemia had more often ischemic ECG changes compared to women with NGT (48.3 vs. 39.7%, P less than 0.05). There was no difference (NS) in the prevalence of verified stroke (3.5 vs. 4.6% in men, 2.7 vs. 2.5% in women) or claudication (7.0 vs. 7.7% in men, 4.6 vs. 4.3% in women) between subjects with asymptomatic hyperglycemia and NGT. In multiple logistic regression analyses, the association between risk factors and MI or ischemic ECG changes in subjects with asymptomatic hyperglycemia was not consistent. CONCLUSION--Elderly subjects with asymptomatic hyperglycemia (particularly men) tended to have an increased prevalence of CHD. Thus, asymptomatic hyperglycemia in the elderly is not a benign phenomenon but is associated with cardiovascular morbidity.