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KMID : 0648320090150040012
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Journal of The Korean Society of Hypertension
2009 Volume.15 No. 4 p.12 ~ p.20
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Dysglycemia in Hypertensive Patients :Clinical Significance of Glucose Tolerance Test
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Kim Young-Kwon
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Abstract
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Concomitant hypertension and diabetes increase the risk of target organ damage, cardiovascular disease (CVD), and mortality.Numerous epidemiologic studies support that blood glucose levels even below the diagnostic level for diabetes are causally related to CVD. CVD is more strongly associated with postload glucose levels than with fasting glucose levels. The European guidelines on diabetes, pre-diabetes, and CVD represent that an oral glucose tolerance test (OGTT) should be carried out in all patients with coronary heart disease. Hypertension is frequently coexistent with obesity and abnormal metabolic state such as dyslipidemia and dysglycemia. However, most epidemiologic data on dysglycemia in hypertensive patients have been based on fasting glucose levels. Studies showing abnormal glucose metabolism estimated by an OGTT are very limited up to now. From studies in general population and in hypertensive patients currently available, in which an OGTT was performed, it is expected that quite many subjects with diabetes or impaired glucose tolerance (IGT) remain undetected. There is no universally accepted guideline that hypertensive patients should be performed an OGTT. Recently, the U.S. Preventive Services Task Force recommends that patients with high blood pressure should be screened for diabetes based on the evidence. Obviously, screening for diabetes incorporates an OGTT, if a fasting glucose level is not diagnostic for diabetes. Screening for diabetes may be a costeffective strategy in the long term. Considering potential benefits of detecting patients with diabetes or IGT and its therapeutic implication of global risk factor control, it makes sense to perform an OGTT in every hypertensive patient.
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KEYWORD
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hypertension, type 2 diabetes, impaired fasting glucose, impaired glucose tolerance, oral glucose tolerance test
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