BMJ  2003;327:290-291 (2 August), doi:10.1136/bmj.327.7409.290-c

Letter

Two groups were different in cardiovascular risk study

The first 150 words of the full text of this article appear below.

EDITOR—Dunder et al compared two different groups and concluded that the incidence of myocardial infarction was significantly higher in the group receiving antihypertensive treatment.¹

Table 1 shows two heterogeneous groups —the group with hypertension (having treatment) had higher blood glucose concentrations, body mass index, and proinsulin values (implying insulin resistance) than the other group, which had normal blood pressure, lower body mass index, and lower glucose concentrations (implying insulin sensitivity). Up to 40% of patients with hypertension are insulin resistant, and insulin resistance is associated with increased cardiovascular risk.^{2 3} Thus the group with hypertension was at a much higher baseline risk of cardiovascular disease than the group with normal blood pressure.

The two groups remain significantly different over the next 10 years. The normal blood pressure group showed less increase in body mass index and glucose concentrations. Dunder et al say that an increase in fasting blood glucose . . . [Full text of this article]

Timmins and District Hospital, Timmins, ON, Canada P4N 8R1 atbeat@ntl.sympatico.ca

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