CLINICAL RESEARCH: HEART FAILURE
The association of fasting glucose levels with congestive heart failure in diabetic adults  65 years
The Cardiovascular Health Study
Joshua I. Barzilay, MD*,*,
Richard A. Kronmal, PhD ,
John S. Gottdiener, MD ,
Nicholas L. Smith, PhD, MPH ,
Gregory L. Burke, MD, MS||,
Russell Tracy, PhD¶,
Peter J. Savage, MD# and
Michelle Carlson, PhD**
* Kaiser Permanente of Georgia and the Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA
Department of Biostatistics, University of Washington, Seattle, Washington, USA
Department of Epidemiology, University of Washington, Seattle, Washington, USA
Department of Cardiology, St. Francis Hospital, Roslyn, New York, USA
|| Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
¶ Department of Pathology, University of Vermont College of Medicine, Colchester, Vermont, USA
# Division of Epidemiology and Clinical Applications, National Heart, Lung, Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
** Center on Aging and Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
Manuscript received July 29, 2003;
revised manuscript received October 15, 2003,
accepted October 20, 2003.
* Reprint requests and correspondence: Dr. Joshua I. Barzilay, Kaiser Permanente of Georgia, 200 Crescent Center Parkway, Tucker, Georgia 30084.
joshua.barzilay{at}kp.org
OBJECTIVES: The purpose of this study was to determine if fasting glucose levels are an independent risk factor for congestive heart failure (CHF) in elderly individuals with diabetes mellitus (DM) with or without coronary heart disease (CHD).
BACKGROUND: Diabetes mellitus and CHF frequently coexist in the elderly. It is not clear whether fasting glucose levels in the setting of DM are a risk factor for incident CHF in the elderly.
METHODS: A cohort of 829 diabetic participants, age  65 years, without prevalent CHF, was followed for five to eight years. The Cox proportional hazards modeling was used to determine the risk of CHF by fasting glucose levels. The cohort was categorized by the presence or absence of prevalent CHD.
RESULTS: For a 1 standard deviation (60.6 mg/dl) increase in fasting glucose, the adjusted hazard ratios for incident CHF among participants without CHD at baseline, with or without an incident myocardial infarction (MI) or CHD event on follow-up, was 1.41 (95% confidence interval 1.24 to 1.61; p < 0.0001). Among those with prevalent CHD at baseline, with or without another incident MI or CHD event on follow-up, the corresponding adjusted hazard ratio was 1.27 (95% confidence interval 1.02 to 1.58; p < 0.05).
CONCLUSIONS: Among older adults with DM, elevated fasting glucose levels are a risk factor for incident CHF. The relationship of fasting glucose to CHF differs somewhat by the presence or absence of prevalent CHD.
|
Abbreviations and Acronyms
| | CHD | = coronary heart disease | | CHF | = congestive heart failure | | CHS | = Cardiovascular Health Study | | DM | = diabetes mellitus | | LV | = left ventricle/ventricular | | MI | = myocardial infarction |
|
This article has been cited by other articles:
|
|
|
|
 
A. Kalogeropoulos, V. Georgiopoulou, S. B. Kritchevsky, B. M. Psaty, N. L. Smith, A. B. Newman, N. Rodondi, S. Satterfield, D. C. Bauer, K. Bibbins-Domingo, et al.
Epidemiology of Incident Heart Failure in a Contemporary Elderly Cohort: The Health, Aging, and Body Composition Study
Arch Intern Med,
April 13, 2009;
169(7):
708 - 715.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Suzuki, R. Katz, N. S. Jenny, N. A. Zakai, M. M. LeWinter, J. I. Barzilay, and M. Cushman
Metabolic Syndrome, Inflammation, and Incident Heart Failure in the Elderly: The Cardiovascular Health Study
Circ Heart Fail,
November 1, 2008;
1(4):
242 - 248.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. A. McAlister, D. T. Eurich, S. R. Majumdar, and J. A. Johnson
The risk of heart failure in patients with type 2 diabetes treated with oral agent monotherapy
Eur J Heart Fail,
July 1, 2008;
10(7):
703 - 708.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. B. Newman, R. M. Boudreau, B. L. Naydeck, L. F. Fried, and T. B. Harris
A Physiologic Index of Comorbidity: Relationship to Mortality and Disability
J. Gerontol. A Biol. Sci. Med. Sci.,
June 1, 2008;
63(6):
603 - 609.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Held, H.C. Gerstein, S. Yusuf, F. Zhao, L. Hilbrich, C. Anderson, P. Sleight, K. Teo, and for the ONTARGET/TRANSCEND Investigators
Glucose Levels Predict Hospitalization for Congestive Heart Failure in Patients at High Cardiovascular Risk
Circulation,
March 20, 2007;
115(11):
1371 - 1375.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. J. Shaw, C. N. Bairey Merz, C. J. Pepine, S. E. Reis, V. Bittner, S. F. Kelsey, M. Olson, B. D. Johnson, S. Mankad, B. L. Sharaf, et al.
Insights From the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part I: Gender Differences in Traditional and Novel Risk Factors, Symptom Evaluation, and Gender-Optimized Diagnostic Strategies
J. Am. Coll. Cardiol.,
February 7, 2006;
47(3_Suppl_S):
S4 - S20.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Nielson and T. Lange
Blood Glucose and Heart Failure in Nondiabetic Patients
Diabetes Care,
March 1, 2005;
28(3):
607 - 611.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
