Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes

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Abstract
Chronic hyperglycemia has been hypothesized to contribute to coronary heart disease (CHD) in individuals with diabetes and nondiabetic individuals, but there is debate regarding whether this relationship is independent of known CHD risk factors. Hemoglobin A1c (HbA1c) reflects long-term glycemic control and tracks well in individuals over time,1 especially when compared with fasting glucose. In persons with diabetes, HbA1c is related to the development of microvascular disease2-4 and is at the center of the clinical management of hyperglycemia. Although there is evidence that HbA1c level is also associated with macrovascular disease in persons with diabetes,5 this relation is controversial.