{"id":42308,"date":"2014-03-25T19:28:46","date_gmt":"2014-03-25T23:28:46","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=42308"},"modified":"2014-03-25T19:28:46","modified_gmt":"2014-03-25T23:28:46","slug":"glucose-measurements-dont-improve-cardiovascular-risk-assessment","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2014\/03\/25\/glucose-measurements-dont-improve-cardiovascular-risk-assessment\/","title":{"rendered":"Glucose Measurements Don&#8217;t Improve Cardiovascular Risk Assessment"},"content":{"rendered":"<p>Although blood glucose and glycated hemoglobin (HbA1c) play a central role in diabetes, the value of these measurements to assess cardiovascular risk has been unclear. Now, in a <a href=\"https:\/\/jama.jamanetwork.com\/article.aspx?articleid=1852370\">paper published in\u00a0<em>JAMA<\/em><\/a>, members of the Emerging Risk Factors Collaboration analyze data from nearly 300,000 people without known diabetes or cardiovascular disease who were enrolled in\u00a073 prospective studies.<\/p>\n<p>The authors found that adding glycemia measures to conventional cardiovascular risk assessment provided little additional prognostic information. Further, adding information about blood glucose did not result in a significant improvement in the classification of people used to help decide about preventive treatment.<\/p>\n<p>One somewhat surprising finding was that four different measures of glycemia independently resulted in a \u00a0J-shaped curve of cardiovascular risk &#8212; although lower glycemia levels were generally associated with lower levels of risk, at the extreme lowest level there was a rebound in risk. This finding &#8220;should encourage further studies to test whether very low glycemia levels are markers of ill health,&#8221; write the authors.<\/p>\n<p>Another nonintuitive finding was that HbA1c measures were &#8220;at least equal&#8221; to fasting, random, and postload plasma glucose levels in assessing risk. &#8220;This finding challenges suggestions that postload glucose levels predict CVD incidence more strongly than do other glycemia measures,&#8221; they say.<\/p>\n<p>The authors conclude: \u201cContrary to recommendations in some guidelines, the current analysis of individual-participant data in almost 300,000 people without known diabetes and CVD at baseline indicates that measurement of HbA1c is not associated with clinically meaningful improvement in assessment of CVD risk.\u201d<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Although blood glucose and glycated hemoglobin (HbA1c) play a central role in diabetes, the value of these measurements to assess cardiovascular risk has been unclear. Now, in a paper published in\u00a0JAMA, members of the Emerging Risk Factors Collaboration analyze data from nearly 300,000 people without known diabetes or cardiovascular disease who were enrolled in\u00a073 prospective [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,7],"tags":[],"class_list":["post-42308","post","type-post","status-publish","format-standard","hentry","category-general","category-prevention"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/42308","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=42308"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/42308\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=42308"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=42308"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=42308"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}