Fasting blood glucose: an underestimated risk factor for cardiovascular death. Results from a 22-year follow-up of healthy nondiabetic men

Diabetes Care. 1999 Jan;22(1):45-9. doi: 10.2337/diacare.22.1.45.


Objective: Because of the available conflicting epidemiological data, we investigated the possible impact of fasting blood glucose as a risk factor for cardiovascular death in nondiabetic men. This study reports the results from a 22-year prospective study on fasting blood glucose as a predictor of cardiovascular death.

Research design and methods: Of the 1,998 apparently healthy nondiabetic men (aged 40-59 years), a total of 1,973 with fasting blood glucose < 110 mg/dl were included in the study in which also a number of conventional risk factors were measured at baseline.

Results: After 22 years of follow-up, 483 men had died, 53% from cardiovascular diseases. After dividing men into quartiles of fasting blood glucose level, it was found that men in the highest glucose quartile (fasting blood glucose > 85 mg/dl) had a significantly higher mortality rate from cardiovascular diseases compared with those in the three lowest quartiles. Even after adjusting for age, smoking habits, serum lipids, blood pressure, forced expiratory volume in 1 s, and physical fitness (Cox model), the relative risk of cardiovascular death for men with fasting blood glucose > 85 mg/dl remained 1.4 (95% CI 1.04-1.8). Noncardiovascular deaths were unrelated to fasting blood glucose level.

Conclusions: Fasting blood glucose values in the upper normal range appears to be an important independent predictor of cardiovascular death in nondiabetic apparently healthy middle-aged men.

MeSH terms

  • Adult
  • Blood Glucose*
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / mortality*
  • Fasting
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Heart Rate
  • Humans
  • Lipids / blood
  • Male
  • Middle Aged
  • Norway
  • Physical Fitness
  • Reference Values
  • Risk Factors
  • Smoking


  • Blood Glucose
  • Lipids