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Glucose intolerance: the hidden danger in hypertensives!

A M Salmasi1, M Dancy

  • 1Hypertension Clinic and the Cardiac Research Unit, Central Middlesex Hospital, London, UK. majeed.salmasi@nwlh.nhs.uk

International Angiology : a Journal of the International Union of Angiology
|September 15, 2005
PubMed

Insights

Systemic hypertension and glucose intolerance significantly increase cardiovascular risk. Early detection of unrecognised glucose metabolism abnormalities in hypertensive patients via oral glucose tolerance tests is crucial for effective management and risk assessment.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Systemic hypertension and abnormal glucose metabolism are independent cardiovascular risk factors.
  • Their coexistence exacerbates cardiovascular morbidity and mortality.
  • Both conditions contribute to arterial stiffness and cardiac remodeling, including left ventricular hypertrophy and diastolic dysfunction.

Purpose of the Study:

  • To highlight the high prevalence of unrecognised glucose metabolism abnormalities in hypertensive patients.
  • To emphasize the inadequacy of current screening methods (fasting plasma glucose, HbA1c) for detecting these abnormalities.
  • To advocate for the routine use of oral glucose tolerance tests in hypertensive patients.

Main Methods:

  • Analysis of oral glucose tolerance test (OGTT) results in patients with systemic hypertension.
  • Comparison of OGTT findings with fasting plasma glucose and glycated haemoglobin levels.
  • Assessment of cardiovascular risk associated with coexisting hypertension and glucose intolerance.

Main Results:

  • 58% of hypertensive patients without a known cardiac history or diabetes have unrecognised glucose metabolism abnormalities (diabetes or impaired glucose tolerance).
  • Fasting plasma glucose and HbA1c lack sensitivity for diagnosing diabetes and cannot identify impaired glucose tolerance in this population.
  • Underestimation of cardiovascular risk occurs when glucose intolerance is not identified.

Conclusions:

  • Oral glucose tolerance tests are essential for early detection of glucose metabolism abnormalities in hypertensive patients.
  • Early identification enables appropriate management and primary preventative measures.
  • Routine OGTT screening in hypertension clinics is recommended to accurately assess cardiovascular risk.

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