Diabetes as a coronary risk factor in Malta

Abstract

In a retrospective survey of 1,118 admissions for acute ischemic heart disease (AIHD) at St. Luke's Hospital in Malta in 1963-72, there were 945 (84.5%) cases of acute myocardial infarction (AMI) and 173 (15.5%) cases of acute coronary insufficiency (ACI). The proportion of patients with diabetes was 30.2% (30.7% in AMI, and 27.7% in ACI; age-corrected rates at greater than or equal to 40 years). This was significantly higher (P less than 0.01) than the corresponding rate of diabetes (20.2%) in the general population of Malta. There was a significantly greater prevalence of diabetes among women than among men with AIHD: the proportion with diabetes was 50.0% among women with AMI and 41.3 among women with ACI. The diabetes was mostly of the maturity-onset type. The high frequency of AIHD among diabetics seemed to be chiefly attributable to the effects of the diabetic state, either directly or indirectly through its association with other risk factors: obesity, physical inactivity, excessive eating and high plasma cholesterol levels. Diastolic hypertension and chronic bronchitis and emphysema associated withe heavy smoking were no more common in diabetics than in nondiabetics with AMI.