Post-challenge blood glucose concentration and stroke mortality rates in non-diabetic men in London: 38-year follow-up of the original Whitehall prospective cohort study

Diabetologia. 2008 Jul;51(7):1123-6. doi: 10.1007/s00125-008-1005-0. Epub 2008 Apr 26.


Aims/hypothesis: While individuals with diabetes have a raised risk of stroke, it is unclear whether hyperglycaemia in non-diabetic populations is related to the development of this disease.

Methods: In this prospective cohort study of 19,019 men, capillary blood was drawn 2 h after consumption of a glucose preparation equivalent to 50 g of anhydrous dextrose. Study participants were then followed for mortality for a maximum of 38 years.

Results: During follow-up of 18,406 non-diabetic men, 13,116 deaths occurred (1,189 by stroke). Plots of stroke mortality rates versus blood glucose identified an upward inflection in risk of death from stroke at about 4.6 mmol/l. This upward inflection in risk could be adequately described using a single linear term above this threshold. A 1 mmol/l increase in blood glucose after this point was associated with a 27% increase in risk of death from stroke (hazard ratio 1.27, 95% CI 1.14-1.42). This increase in risk was partially attenuated by adjustment for covariates (1.17, 1.04-1.31) but remained statistically significant at conventional levels. Similar observations were made when all-cause mortality was the outcome of interest, although the magnitude of the association with blood glucose was somewhat lower.

Conclusions/interpretation: An incremental elevation in stroke mortality rates occurs with increasing post-challenge blood glucose.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose*
  • Follow-Up Studies
  • Humans
  • Hyperglycemia / mortality*
  • London / epidemiology
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Stroke / mortality*


  • Blood Glucose