To the Editor: In their discussion of the relationship
between hyperglycemia and atherosclerosis, Dr Beckman and colleagues1 did not discuss the evidence linking postprandial
hyperglycemia to cardiovascular disease. For example, in the Honululu Heart
Program,2 which followed up more than 6000
men of Japanese ancestry for 12 years, the rate of fatal cardiac disease increased
linearly with the degree of postchallenge hyperglycemia. In the Rancho Bernardo
cohort,3 cardiovascular mortality more than
doubled among women, but not men, with abnormal postprandial hyperglycemia
(>200 mg/dL [11.1 mmol/L]) but with normal fasting plasma glucose (<126
mg/dL [7 mmol/L]).3 Moreover, postprandial
glucose values, but not fasting plasma glucose or glycohemoglobin levels,
were significantly related to increased intima-media thickness of carotid
arteries, a marker of atherosclerosis.4
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