Association between one-hour post-load plasma glucose levels and vascular stiffness in essential hypertension

PLoS One. 2012;7(9):e44470. doi: 10.1371/journal.pone.0044470. Epub 2012 Sep 13.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Female
  • Glucose Intolerance / blood
  • Glucose Intolerance / physiopathology
  • Glucose Tolerance Test
  • Hemodynamics
  • Humans
  • Hypertension / blood
  • Hypertension / physiopathology*
  • Male
  • Middle Aged
  • Regression Analysis
  • Vascular Stiffness / physiology*

Substances

  • Blood Glucose

Grant support

No current external funding sources for this study.