Abnormal glucose tolerance is the dominant risk factor in South African Indian women with myocardial infarction.

Risk factors for coronary artery disease were determined at least 3 months following myocardial infarction in 90 Indian women between the ages of 26 and 60 years. The risk factors were analysed according to age (greater than 45 vs. less than or equal to 45 years) and also their prevalence was compared to that of 76 healthy age- and sex-matched Indian controls. In the total patient cohort, 98% had at least one major coronary risk factor. Older patients (greater than 45 years) were characterized by a higher risk profile: mean number of risk factors 2.7 compared to 1.9 in women less than or equal to 45 years (p less than 0.005). Diabetes mellitus was the commonest risk factor and was present in 78% of patients. While diabetes mellitus was detected with similar frequency in both age groups of patients (79 and 77%), hypertension, lipid aberrations and family history of myocardial infarction were encountered more frequently in the older women. Compared to the control population, the patients had a higher frequency of lipid abnormalities (p less than 0.0005), obesity (p less than 0.01) and a positive family history of myocardial infarction in first-degree relatives (p less than 0.01). The prevalence of smoking was low both among patients (10%) and control subjects (5%). This analysis thus indicated that of the identifiable risk factors, diabetes mellitus was most prominent in all age groups with hypertension and lipid aberrations being significant synergistic factors in the older women.