Document Detail

Does impaired glucose tolerance predict hypertension? A prospective analysis.
MedLine Citation:
PMID:  8720605     Owner:  NLM     Status:  MEDLINE    
This study evaluates prospectively the relationship between impaired glucose tolerance (IGT) and blood pressure. From a population of 1376 men and women aged 40-59 years, all those with IGT (n = 54) plus 133 age- weight- and sex-matched normoglycaemic control subjects were selected after excluding treated hypertensive patients. Blood pressure, fasting and postload blood glucose and plasma insulin were measured. At 11.5 years after the first visit 76% of the IGT patients and 80% of the control subjects were re-examined. At baseline blood pressure was significantly higher in IGT patients than in control subjects (systolic 135.5 +/- 2.3 vs 127.9 +/- 1.4 mmHg, p < 0.001; and diastolic 88.0 +/- 1.5 vs 84.7 +/- 0.7 mm Hg, p < 0.05) independent of age, gender, weight, antihypertensive medication and insulinaemia. Accordingly, hypertension was more frequent in subjects with IGT (odds ratio 2.1, 95% confidence, interval (CI) 0.9-4.9). Postload insulin was significantly associated with hypertension--both at univariate and multivariate analysis--in normoglycaemic subjects, but not in those with IGT. At follow-up systolic blood pressure increased in both groups; the increase was smaller in patients with IGT (6.0 +/- 2.4 vs 12.3 +/- 1.6 mm Hg p < 0.05). Likewise, the 11.5 years' cumulative incidence of hypertension was not significantly different in subjects with baseline IGT or normoglycaemia; if anything it was lower in the IGT group (odds ratio 0.36, 95% CI 0.1-1.2). In multivariate analysis incidence of hypertension was associated positively with baseline blood pressure (p < 0.0003) and negatively with IGT status p < 0.03), while no significant association was found with insulin. In conclusion, the findings of this study question IGT as a risk factor for hypertension. Furthermore, these data do not indicate a major role for hyperglycaemia and hyperinsulinaemia per se in the aetiology of hypertension and suggest that IGT and hypertension share one or more pathogenetic factor(s) (i.e., insulin resistance, hyperactivity of the sympathetic nervous system, etc.), which induce deterioration of blood pressure control first, and hyperglycaemia later.
O Vaccaro; G Imperatore; V Iovino; C Iovine; A A Rivellese; G Riccardi
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetologia     Volume:  39     ISSN:  0012-186X     ISO Abbreviation:  Diabetologia     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-10-23     Completed Date:  1996-10-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0006777     Medline TA:  Diabetologia     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  70-6     Citation Subset:  IM    
Institute of Internal Medicine and Metabolic Diseases, Federico II University, Naples, Italy.
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MeSH Terms
Age Factors
Analysis of Variance
Blood Glucose / analysis,  metabolism*
Blood Pressure
Body Weight
Confidence Intervals
Glucose Intolerance / physiopathology*
Glucose Tolerance Test*
Hypertension / blood,  epidemiology*,  physiopathology
Insulin / blood
Middle Aged
Multivariate Analysis
Odds Ratio
Prospective Studies
Reference Values
Regression Analysis
Sex Characteristics
Sex Factors
Reg. No./Substance:
0/Blood Glucose; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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