Study Of Glucometabolic Abnormality In The Patients With Essential Hypertension

Objective: To clarify the status of the subjects with combined essential hypertension(EH) and glucose metabolic abnormality via analysis of clinical characteristics,and so as to discover,diagnose and treat them earlier;propose the scientifical treatment standards and control strategies of hypertension ;Let the clinicians concern with the status of the subjects with combined EH and glucometabolic abnormality; In order to improve the patients'quality of life ,lessen the burden of social economy and decrease mortality and morbility.Methods: All the inpatients with EH in cardiology and endocrinology departments of the second affiliated hospital of Nanchang University and 334 Hospital of Nanchang Province were consecutively recruited from Jun 1,2005 to Dec 31,2006.A total of 1166 patients (male667,female499)with EH were included in the study.aging from 28 to 94 years old.Questionnaire survey was done in everyone,including sex,age,somking,acohol consumption,family history of EH and type 2 diabetes mellitus(T2DM),systolic and diasystolic pressure when EH was diagnosed,the course of EH.The blood pressure,body mass index(BMI),wrist circumference(W),hip circumference(H),wrist-to-hip rate(WHR),blood glucose,blood lipid were assayed in all the subjects.Patients with previously known diabetes mellitus(DM)(209 patients) were not asked to perform oral glucose tolerance test(OGTT),the others would perform OGTT to characterize the glucose metabolism status.detecting fasting plasm glucose and 2 hours plasm glucose after taking glucose. Patients were divided into five groups(NGT,IFG,IGT,IFG+IGT,DM) respectively according to OGTT and comparisons in lipid,blood pressure,BMI and so on would be conducted among the five groups.Statistical analyses were conducted using SPSS for windows ,version 11.5.Data of continuous variables were expressed as means±SD.Trends for means values and proportions were calculated with ANOVA and theχ2 test.Logistic regression was used to analyze the risk factors of the development of T2DM and impaired glucose regulation(IGR) .P<0.05 was considered statistically significant. Results:①The total prevalence of abnormal glucose metabolism was 64.66%,the prevalences of patients with DM,isolated-impaired fasting glucose(I-IFG),isolated-impaired glucose tolerance(I-IGT) and IFG+IGT were 23.33%,10.03%,25.04% and 6.26% in inpatients with EH respectively②BMI,W,course of EH,systolic blood pressure(SBP),FPG,2hPG,Triglyceride(TG),total cholesterol(TC),LDL-cholesterol (LDL-C) were significantly higher in the groups of DM,IFG,IGT,IFG+IGT than in the group of normal glucose tolerance(NGT)(P<0.01);HDL- cholesterol(HDL-C) was lower in the groups of DM,IFG,IGT,IFG+IGT than in the group of NGT,but there was no statistical significance between IFG and NGT(P>0.05),p<0.01 in the other three groups. Comparisons among the groups of DM,IFG,IGT,IFG+IGT :SBP,FPG,2hPG,TC were significantly higher in the group of DM than in the others(P< 0.01);HDL-C was significantly lower in the group of DM than in the others(P< 0.01);Among these four groups,there were no statistical significance among age,BMI,W,WHR,course of EH,diastolic blood pressure(DBP),TG③Spearman rank correlation shows that history of type 2 diabetes mellitus,course of EH,W,WHR,BMI,SBP,TG,TC,LDL-C,HDL-C were positive correlated with FPG and 2hPG respectively(P<0.01);Sex,age,smoking,alcohol computation,history of EH,DBP were not correlated with with FPG and 2hPG.④WHR,family history of DM,course of EH,SBP,TC,LDL-C and HDL-C were positively associated with the development of DM in patients with EH independently,it's suggested that male,central obesity, positive family history of DM,long course of EH,high SBP,hyperlipidemia were the risk factors for the development of DM in patients with EH; acohol consumption,BMI,family history of hypertension,SBP,TG and LDL-C were positively associated with the development of IGR in patients with EH independently, it's suggested that acohol consumption,central obesity,positive family history of hypertension,high SBP,hyperlipidemia were the risk factors for the development of IGR in patients with EH.Conclusion:①The frequency of disturbed glucose metabolism is considerably high in inpatients with EH, and postprandial hyperglycemia is more common.The prevalence of abnormal glucose metabolism would be obviously underestimated by measuring FPG only.②The prevalence of overweight/obesity and hyperlipemia is common in patients with EH. They are positive associated with glucose metabolism and are also the risk factors for the development of abnormal glucose metabolism.③IFG with overweight/obesity and hyperlipidemia is common in patients with EH,it indicates that we must pay close attention to IFG,intervene it at a pinch.④blood glucose was positive correlated with blood pressure,the correlation was developed before DM,and the correlation between 2hPG and blood pressure was closer than FPG ;⑤male,central obesity,positive family history of DM,long course of EH,high SBP,hyperlipidemia were the risk factors for the development of DM in patients with EH; acohol consumption,central obesity,positive family history of hypertension,high SBP,hyperlipidemia were the risk factors for the development of IGR in patients with EH.