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Does impaired glucose tolerance predict hypertension? A prospective analysis

O Vaccaro1, G Imperatore, V Iovino

  • 1Institute of Internal Medicine and Metabolic Diseases, Federico II University, Naples, Italy.

Diabetologia
|January 1, 1996
PubMed
Summary

Impaired glucose tolerance (IGT) does not appear to be a significant risk factor for developing hypertension. This study suggests shared underlying causes, like insulin resistance, rather than IGT directly causing high blood pressure.

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Area of Science:

  • Cardiovascular Health
  • Metabolic Disorders
  • Epidemiology

Background:

  • Impaired glucose tolerance (IGT) is a metabolic condition characterized by higher-than-normal blood glucose levels.
  • The relationship between IGT and the development of hypertension requires further prospective investigation.
  • Understanding these links is crucial for managing cardiovascular and metabolic disease risk.

Purpose of the Study:

  • To prospectively evaluate the association between impaired glucose tolerance (IGT) and blood pressure.
  • To determine if IGT is a risk factor for developing hypertension over an 11.5-year follow-up period.
  • To explore the roles of hyperglycemia and hyperinsulinemia in the etiology of hypertension.

Main Methods:

  • A prospective study involving 1376 adults aged 40-59, selecting 54 with IGT and 133 matched controls.

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  • Exclusion of treated hypertensive patients, followed by measurements of blood pressure, glucose, and insulin.
  • Re-examination of 76% of IGT patients and 80% of controls after 11.5 years.

    • Main Results:

    • Baseline blood pressure was significantly higher in the IGT group compared to controls.
    • Hypertension was more frequent at baseline in subjects with IGT.
    • Over 11.5 years, systolic blood pressure increased less in the IGT group, and the incidence of hypertension was not significantly different, possibly lower in the IGT group.
    • Multivariate analysis indicated baseline blood pressure and IGT status (negatively) were associated with hypertension incidence, not insulin levels.

    Conclusions:

    • The study questions impaired glucose tolerance (IGT) as a direct risk factor for hypertension.
    • Hyperglycemia and hyperinsulinemia do not appear to be major etiological factors for hypertension.
    • IGT and hypertension likely share common underlying pathogenetic factors, such as insulin resistance or sympathetic nervous system hyperactivity, which may lead to blood pressure deterioration before hyperglycemia occurs.