Glucose Measurements Don't Improve Cardiovascular Risk Assessment — Physician’s First Watch

Medical News |
March 26, 2014

Glucose Measurements Don't Improve Cardiovascular Risk Assessment

By Larry Husten

Adding glycemia measures to conventional cardiovascular risk assessment provides little additional prognostic information in those without diabetes or CVD, a JAMA study finds.

Researchers analyzed data on nearly 300,000 people without known diabetes or CVD from 73 prospective studies. They found that adding hemoglobin A1c, fasting glucose, random glucose, or postload glucose offered little improvement to standard cardiovascular risk assessment and did not help to better classify participants to inform decisions about preventive treatment.

One somewhat surprising finding: the four different measures of glycemia independently resulted in a J-shaped curve of cardiovascular risk — although lower glycemia levels were generally associated with lower levels of risk, at the extreme lowest level there was a rebound in risk.

The authors conclude: "Contrary to recommendations in some guidelines, the current analysis ... indicates that measurement of HbA1c is not associated with clinically meaningful improvement in assessment of CVD risk" in patients without known diabetes or CVD.

Adapted from CardioExchange

Reader Comments (1)

Paul helman,MD Physician, Internal Medicine, North shore university health systems

Using glycemic as a single risk factor unrealistic ally separates it from a spectrum of derangement reflecting carbohydrate intolerance which may eventually be characterized as "Metabolic Syndrome". It deflects attention away the genesis of cardiovascular disease which lies in large measure on that carbohydrate intolerance which is evolutionary and significantly effects two out every three of us.

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