Glucose Tolerance and Blood Pressure in Two Population Samples: Their Relation to Diabetes Mellitus and Hypertension

Abstract

The relationship between blood pressure and the blood sugar concentration measured two hours after a 50 g oral glucose load has been examined in two population surveys-the Whitehall and Bedford Surveys. In the Whitehall Survey, which was conducted in men above the age of 40, there was a positive, significant correlation between blood sugar and blood pressure (systolic and diastolic) which was independent of common associations with age, body mass index (BMI) and heart rate. In the Bedford Survey, systolic blood pressures were significantly higher in newly detected diabetics and borderline diabetics, both men and women, than in normoglycaemic controls after adjustment of blood pressures for age and BMI. However, in the stratified random sample of the cooperating Bedford population, only amongst women was the blood sugar significantly and independently correlated with the systolic blood pressure. Evidence is presented and discussed that autonomic, neurohumoral factors may play some part in the pathogenesis of maturity onset diabetes.

Prevalence of small vessel and large vessel disease in diabetic patients from 14 centres

“…This absence of systematically different systolic (and diastolic) pressures in diabetic compared with non-diabetic subjects was also noted in the Whitehall Study when pressures in diabetic patients (men 40-64 years, mean systolic 137 mmHg) were measured in ignorance of their diagnosis and at the same time as a group of approximately 18 000 non-diabetic individuals (mean systolic 136 mmHg) [24]. There is inconsistency Cigarette smoking habits also show major variations between centres.…”

Etiology and Prevalence of Hypertension in Diabetic Patients

“…This relationship was present in both men and women after appropriate adjustment for age and weight. In the Whitehall study, patients with impaired glucose tolerance were found to have significant elevations of mean blood pressure, but the results were not significant for patients with overt diabetes (10). In the Framingham study, systolic hypertension was ~1.5 times more prevalent in diabetic than in nondiabetic patients, with the risk being higher in women than in men (11,12).…”

“…They reported a 54% increase in the prevalence of hypertension (defined as a blood pressure >160/95 mmHg) in the diabetic patients. In the Bedford survey, patients with newly diagnosed diabetes as well as those with glucose intolerance were found to have a significantly higher prevalence of systolic hypertension compared with patients with normal glucose tolerance (10). This relationship was present in both men and women after appropriate adjustment for age and weight.…”

Preventing end stage renal disease in diabetic patients — genetic aspect (part I)

“…Since systemic blood pressure is such an important factor for initiation and progression of diabetic nephropathy, we became interested in whether hyperglycaemia (acute, sub-acute or chronic), per se, induces an increase in systemic blood pressure. Evidence supporting this theory came from population-based studies of non-diabetic children 63 and diabetic and non-diabetic adults, 64 demonstrating a direct association between blood glucose level and arterial blood pressure. Some glycaemic intervention studies have shown an increase in systemic blood pressure after days/weeks of hyperglycaemia, 59,65 whereas this was not demonstrated by others.…”