Should we do an oral glucose tolerance test in hypertensive men with normal fasting blood-glucose?

Abstract

The objective of this study was to examine, using the new WHO criteria for diabetes mellitus, whether insulin and glucose before and after an oral glucose tolerance test would predict cardiovascular mortality in hypertensive men with normal fasting blood glucose. A standard oral glucose challenge was performed after an overnight fast in 113 hypertensive men with either hypercholesterolaemia or smoking. These patients were recruited from an on-going risk factor intervention study. The mean observation time was 6.3 years. During follow-up there were 10 cardiovascular deaths. The Cox regression analyses showed an independent and significant association (P Ͻ 0.05) between blood glucose 120 min

Should oral glucose tolerance test be a routine examination after a myocardial infarction?

“…This observation is in line with numerous previous reports [1,4,9]. This observation further emphasis the relevance of identification of these high-risk subjects.…”

“…There are also studies indicating that people with prediabetic conditions, such as impaired glucose tolerance (IGT), have an increased risk for cardiovascular disease [3,4]. The growing knowledge about the close relationship between DM and cardiovascular morbidity and intervention studies showing that the poor prognosis in both type I and type II DM can be improved [5 -7], has put focus on the relevance of identification of patients with IGT and DM.…”

Is Nondiabetic Hyperglycemia a Risk Factor for Cardiovascular Disease?

“…One study reporting postchallenge blood glucose level as a continuous exposure was a heavily weighted outlier. 48 Removing that study increased the overall pooled RR for a 20-mg/dL (1.1-mmol/L) increase in postchallenge blood glucose level to 1.05 (95% CI, 1.04-1.07) and the pooled RR for cohorts of men to 1.04 (95% CI, 1.02-1.06). The difference in the pooled RR for cohorts of men and the pooled RR for cohorts of women and mixed-sex cohorts remained significant (P = .03).…”

Cortisol secretion and abnormalities of glucose metabolism in nondiabetic patients with hypertension

“…IGT is associated with insulin resistance and is highly prevalent in patients with hypertension anticipating the occurrence of new onset diabetes [7]. IGT can be detected only by OGTT and because of its predictive power of diabetes OGTT was suggested as a general practice in all hypertensive patients [33]. Moreover, IGT itself confers a higher risk to experience major cardiovascular events later in life [34], and past studies conducted in hypertensive patients with IGT reported evidence of increased prevalence of cardiac [35] and vascular [36] subclinical damage.…”