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Diabetes Care, Vol 2, Issue 2 154-160, Copyright © 1979 by American Diabetes Association
Coronary heart disease incidence and cardiovascular mortality in Busselton with reference to glucose and insulin concentrations
TA Welborn and K Wearne
In the 1966 study of the population of Busselton, Australia, blood sugar
and serum insulin levels were measured one hour after an oral glucose load,
in addition to the conventional cardiovascular risk factors. The six-year
incidence of coronary heart disease (CHD) and the 12-yr mortality from CHD
and from all cardiovascular diseases is described in relation to the
initial baseline variables measured using the upper 20th percentile values
(age-specific and sex-specific) to define the risk ratios. In younger
subjects (ages less than 60 yr), elevated blood pressure levels for both
sexes (risk ratios from 2.9 to 5.2) and elevated serum cholesterol
concentrations for males (risk ratios from 3.0 to 3.3) were strong
predictors of cardiovascular risk. In men aged 60 to 69 yr, those with
upper range one-hour serum insulin concentrations showed marked
associations with the six-year incidence of CHD, the 12-yr mortality from
CHD, and the 12-yr mortality from all cardiovascular diseases (risk ratios
were 2.0, 2.3, and 2.4, respectively). The relationship of elevated serum
insulin and cardiovascular mortality persisted when males of all ages were
analyzed, and it appeared to be independent of the other major risk
factors. In females, no association between serum insulin and CHD or
cardiovascular disease could be found. Although the age and sex specific
upper 20th percentile values for one-hour blood sugar concentrations showed
a low grade association in patients with subsequent cardiovascular disease
end points, more noticeable risk ratios were demonstrated at the higher
blood sugar level of 200 mg/100 ml or greater (in the age group 60 yr and
over, risk ratios were 2.2 in males and 2.6 in females.

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