Association Between Glycosylated Hemoglobin and Cardiovascular Events and Mortality in Older Adults without Diabetes Mellitus in the General Population: The Leiden 85-Plus Study.

Abstract

To examine the association between glycosylated hemoglobin (HbA1c) and incident cardiovascular disease and mortality in 85-year-old individuals without diabetes mellitus from the general population. Population-based prospective follow-up study. General population. Individuals without known diabetes mellitus (N=445, n=291 female). HbA1c levels were categorized into three groups (<5.0% (31mmol/mol), 5.0-5.7% (31-39mmol/mol; reference), 5.7-6.5% (39-48mmol/mol)). At baseline, a history of myocardial infarction (MI) was more prevalent in subjects in the highest HbA1c group (18%) than in the reference group (7%) (P=.001). Prospectively, those with the highest level of HbA1c at baseline had a risk of incident MI during the 5-year follow-up that was 3.6 (95% confidence interval=1.5-8.3) times as great as that of the reference group. No association was found between HbA1c level and incident stroke, cardiovascular mortality, or all-cause mortality. In individuals aged 85 and older without diabetes mellitus, higher HbA1c is associated with greater risk of MI but not with stroke and mortality.