Analysis Of Cardiovascular Risk Factors In Prehypertensive Patients With Impaired Glucose Regulation

With the development of economy and medical care, traditional spectrum of disease is altering.The prevalence of non-infectious diseases greatly increased,like hypertension and diabetes mellitus. These two diseases are the major causes of the cardiovascular events.Prehypertension and prediabetes is the early stage of hypertension and diabetes mellitus,respectively.These pre-diseases are the risk factors of cardiovascular events likewise. Epidemiologic study showed that there is high prevalence of co-existing prehypertension and prediabetes in china. However,there is no clear information about the metabolic feature of the these special patients.ObjectiveThis study was undertaken to investigate the change of insulin resistance and islet β cell function in subjects with euglycemia and prehypertention and to estimate clinical characteristics and associated cardiovascular risk profiles in prehypertentive patients with impaired glucose regulation.MethodsCross-sectional and cluster sampling method were used in2158residents aged from35-75in Shandong. After an overnight fast, participants underwent an oral glucose-tolerance test, and fasting and2-hour plasma glucose levels were measured to identify undiagnosed diabetes and pre-diabetes. Previously diagnosed diabetes was determined on the basis of self-report.Results1. The prevalence of prehypertension and hypertension in Shandong province was40.1%(standardized rate is39.1%) and40.4%(standardized rate is37.1%),respectively.The prevalence of prehypertension increased up to the50and then decreased.2. The prevalence of IGR is higher in subjects with prehypertension than normal blood pressure (P<0.01), both of the prevalence of IGR and DM were higher in subjects with hypertension than normal blood pressure (P＜0.01)3. HOMA-βand stumvoll index were lower in subjects with high blood pressure, while LOG(HOMA-IR) was lower in subjects with normal blood pressure(P<0.05).4. SBP was negatively correlated with HOMA-β,BMI and age was the independent factors of the stumvoll index and LOG(HOMA-IR)(P＜0.05).5. The prehypertensive subjects were classified into simple prehypertensive group (group I, n=510), prehypertension with impaired glucose regulation (group II, n=278) and prehypertension with diabetes (group III, n=77). Compared with the group I, patients in group II had a higher value of age,BMI,waist circumference,CHOL,TG,LDL-C(P<0.01).Age,WHR,TG in group III showed a higher level than that in group I and group Ⅱ (all P<0.05or P<0.01),the value of waist circumference,CHOL,LDL-C was higher than that in group I (P<0.01),patients in groupIII had a lower value of HDL-C(P<0.05).6. The detection rate of obesity and hyperlipidemia is higher in group II and groupIII(all P＜0.05or P＜0.01).Patients in group II and group Ⅲare more likely to have2or more cardiovascular risk factors than group I (P＜0.05or P＜0.01). 7. Age(OR=1.035,95%CI:1.018-1.053), BMI(OR=1.052,95%CI:1.005-1.101) LDL-C(OR=1.219,95%CI:1.019-1.460) proved to be independent predictors of impaired glucose regulation(all P＜0.05or P＜0.01).Conclusion1. The prevalence of prehypertension and hypertension in Shandong province was40.1%(standardized rate is39.1%) and40.4%(standardized rate is37.1%)2. The prevalence of IGR is higher in subjects with prehypertension than normal blood pressure, both of the prevalence of IGR and DM were higher in subjects with hypertension than normal blood pressure.3. Insulin resistance and islet dysfunction may exist in subjects with prehypertension.4. Prehypertensive patients with higher BMI,LDL-C,or older age were more likely to have impaired glucose regulation.Prehypertension with impaired glucose regulation is frequently accompanied with obesity and hyperlipidemia.