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(Hypertension. 2008;51:945.)
© 2008 American Heart Association, Inc.

Original Articles

Glucose Homeostasis in Hypertensive Subjects

From the Central Satakunta Health Federation of Municipalities (P.K.), Harjavalta, Finland; Departments of Surgery (P.A.) and Family Medicine (P.J.), Satakunta Hospital District, Pori, Finland; Departments of Pulmonary Diseases (T.S.) and Medicine (I.K.), Turku University Hospital, Turku, Finland; Sleep Research Unit (T.S.), Department of Physiology, University of Turku, Turku, Finland.

Correspondence to Päivi Korhonen, Jokikatu 3, 29200 Harjavalta, Finland. E-mail paivi.e.korhonen{at}fimnet.fi

The objective of this study was to estimate the prevalence of undiagnosed impaired glucose homeostasis in hypertensive subjects in the general population. The most reasonable screening strategy for glucose disorders was also assessed. We carried out an oral glucose tolerance test for 1106 hypertensive subjects aged 45 to 70 years without previously diagnosed diabetes or cardiovascular disease. Blood pressure, waist circumference, body mass index, and plasma lipids were also measured. Type 2 diabetes was found in 66 (6%) of the subjects, impaired glucose tolerance in 220 (20%), and impaired fasting glucose in 167 (15%). If we had carried out an oral glucose tolerance test only for those hypertensive subjects with fasting plasma glucose 5.6 mmol/L, we would have missed 40% of the patients with impaired glucose tolerance. The International Diabetes Federation criteria of metabolic syndrome identified 96% of all the cases of type 2 diabetes and 88% of all the cases of impaired glucose tolerance. The prevalence of central obesity was alarming: 90% of the women and 82% of the men had a waist circumference 80 cm or 94 cm, respectively. Impaired glucose homeostasis and central obesity are common in hypertensive subjects. An oral glucose tolerance test is reasonable to carry out at least for the hypertensive subjects with metabolic syndrome. Weight stabilization is an important goal to treat hypertensive patients.

Key Words: hypertension • oral glucose tolerance test • impaired fasting glucose • impaired glucose tolerance • type 2 diabetes • metabolic syndrome