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April 20, 1979

High plasma insulin level a prime risk factor for heart disease

JAMA. 1979;241(16):1665. doi:10.1001/jama.1979.03290420003001

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A recently concluded five-year prospective study of risk factors for coronary heart disease (CHD) shows high plasma insulin levels to have the greatest predictive value. This is true whether the risk factors are considered singly or in combination.

The study is the first reported prospective one to assess the importance of plasma insulin levels as a CHD risk factor.

Previous clinical and experimental evidence has suggested that high plasma insulin levels (which interfere with carbohydrate and fat metabolism) might enhance the development of atherosclerosis. This appears to be true for diabetics as well as for some persons with atherosclerotic vascular disease who have been found to have high plasma insulin levels after a glucose load. In addition, laboratory experiments have indicated that high insulin levels may promote atherosclerosis by leading to smooth muscle cell proliferation, inhibition of lipolysis, and an increased synthesis of lipids in the arterial wall.

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