Key result
In newly diagnosed hypertensive patients with normal glucose tolerance, a 1-hour post-load plasma glucose level ≥/dl was associated with higher pulse wave velocity compared to levels </dl.
Why the study?
Does a 1-hour post-load plasma glucose ≥155 mg/dl correlate with increased vascular stiffness in newly diagnosed hypertensive patients with normal glucose tolerance?
Cross-Sectional (n=584)
No
Does a 1-hour post-load plasma glucose ≥155 mg/dl correlate with increased vascular stiffness in newly diagnosed hypertensive patients with normal glucose tolerance?
In newly diagnosed hypertensive patients with normal glucose tolerance, a 1-hour post-load glucose ≥155 mg/dl identifies individuals with increased arterial stiffness and a higher cardiovascular risk profile.
Answers are grounded in this paper and cite their sources.
May flag higher vascular risk in new hypertensives with normal glucose; hypothesis-generating, needs longitudinal data before practice change.
OBJECTIVES: Pulse wave velocity (PWV) is a surrogate end-point for cardiovascular morbidity and mortality. A plasma glucose value ≥155 mg/dl for the 1-hour post-load plasma glucose during an oral glucose tolerance test (OGTT) is able to identify subjects with normal glucose tolerance (NGT) at high-risk for type-2 diabetes (T2D) and for subclinical organ damage. Thus, we addressed the question if 1-hour post-load plasma glucose levels, affects PWV and its central hemodynamic correlates, as augmentation pressure (AP) and augmentation index (AI). METHODS: We enrolled 584 newly diagnosed hypertensives. All patients underwent OGTT and measurements of PWV, AP and AI. Insulin sensitivity was assessed by Matsuda-index. RESULTS: Among participants, 424 were NGT and 160 had impaired glucose tolerance (IGT). Of 424 NGT, 278 had 1-h post-load plasma glucose <155 mg/dl (NGT<155) and 146 had 1-h post-load plasma glucose ≥155 mg/dl (NGT≥155). NGT≥155 had a worse insulin sensitivity and higher hs-CRP than NGT<155, similar to IGT subjects. In addition, NGT ≥155 in comparison with NGT<155 had higher central systolic blood pressure (134±12 vs 131±10 mmHg), as well as PWV (8.4±3.7 vs 6.7±1.7 m/s), AP (12.5±7.1 vs 9.8±5.7 mmHg) and AI (29.4±11.9 vs 25.1±12.4%), and similar to IGT. At multiple regression analysis, 1-h post-load plasma glucose resulted the major determinant of all indices of vascular stiffness. CONCLUSION: Hypertensive NGT≥155 subjects, compared with NGT<155, have higher PWV and its hemodynamic correlates that increase their cardiovascular risk profile.
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Sciacqua et al. (2012) conducted a cross-sectional in Essential Hypertension (n=584). 1-hour post-load plasma glucose ≥155 mg/dl vs. 1-hour post-load plasma glucose <155 mg/dl was evaluated on Pulse wave velocity (PWV) (p=<0.0001). In newly diagnosed hypertensive patients with normal glucose tolerance, a 1-hour post-load plasma glucose level ≥/dl was associated with higher pulse wave velocity compared to levels </dl.
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