New Culprit in Heart Disease?

Fresh clues pointing to causes of heart disease appear regularly, and new styles in preventive medicine follow inevitably. Researchers have urged programs of regular exercise and have warned against smoking. Doctors have spelled out the dangers of excess weight; others have worried about weight fluctuation caused by repeated crash diets. More recently, physicians have concentrated on cholesterol and other fats. Now they have tracked down another apparent culprit.

After a six-year study of community health patterns in a small Michigan city, a team of University of Michigan scientists found that blood sugar levels provide a further indication of heart disease risk along with blood fats and high blood pressure, two factors now most commonly linked with heart disease. Though it is known that an elevated sugar level often indicates diabetes, and diabetes in turn often leads to atherosclerosis, the Michigan study, reported in the Annals of Internal Medicine, marks the first large-scale study that links blood sugar to heart-and-artery disease.

Led by Dr. Thomas Francis Jr., the head of Michigan's epidemiology department, the team chose Tecumseh, Mich. (pop. 9,500), as typical of the U.S. heartland. Settled in 1824, the town has several industries, a busy main street and a fringe of farms. The researchers arrived in 1959, persuaded 8,600 residents, nine-tenths of the community, to give details of their past family and medical history and to visit a clinic where doctors took blood and urine samples, electrocardiograms, chest X rays, along with complete physical examinations. Then the doctors plotted the frequency of coronary, hypertensive, rheumatic and congenital heart disease, and of congestive heart failure in a variety of sex and age groups. They found that along with cholesterol level and blood pressure, blood sugar level is an additional significant factor in predicting the probability of heart disease.

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