HbA1c and the Risks for All-Cause and Cardiovascular Mortality in the General Japanese Population NIPPON DATA90

OBJECTIVEdAssociations between HbA1c and cardiovascular diseases (CVD) have been reported mainly in Western countries. It is not clear whether HbA1c measurements are useful for assessing CVD mortality risk in East Asian populations. RESEARCH DESIGN AND METHODSdThe risk for cardiovascular death was evalu-ated in a large cohort of participants selected randomly from the overall Japanese population. A total of 7,120 participants (2,962men and 4,158 women; mean age 52.3 years) free of previous CVD were followed for 15 years. Adjusted hazard ratios (HRs) and 95 % CIs among categories of HbA1c (,5.0%, 5.0–5.4%, 5.5–5.9%, 6.0–6.4%, and$6.5%) for participants without treatment for diabetes and HRs for participants with diabetes were calculated using a Cox proportional hazards model. RESULTSdDuring the study, there were 1,104 deaths, including 304 from CVD, 61 from coronary heart disease, and 127 from stroke (78 from cerebral infarction, 25 from cerebral hemorrhage, and 24 from unclassified stroke). Relations to HbA1c with all-cause mortality and CVD death were graded and continuous, and multivariate-adjusted HRs for CVD death in par-ticipants with HbA1c 6.0–6.4 % and$6.5%were 2.18 (95%CI 1.22–3.87) and 2.75 (1.43–5.28)