Screening And Analyzing Of Glucose Metabolism In 1368 Patients With Essential Hypertention In Shan Dong Province

Background: Essential hypertension and diabetes mellitus (DM) exist the common pathologic basis, and they are both the two major components of metabolic syndrome (MS) . Studies show that compared to simple hypertensive patients without diabetes, the incidence of cardiovascular events in patients with hypertension and DM increased by 2 times. Comprehensive interventions of multiple risk factors existing in hypertensive patients are very important in reducing high blood pressure (HBP) complications. In 2006, the investigation of glucose metabolism in patients with coronary artery disease study (China Heart Survey) show: the total prevalence rate of abnormal glucose metabolism in hospitalization patients with coronary heart disease was 76.9%. Without oral glucose tolerance test, only by fasting blood glucose testing alone (FPG), there will have 87.4% patients with abnormal glucose regulation and 80. 5% patients with DM missed. But now we do not have the corresponding clinical data of glucose metabolism status in hypertensive patients in Shandong province, so we launched the screening of glucose metabolism status in patients with essential hypertension in Shandong Province and hoped to get the epidemiological data of abnormal glucose metabolism in patients with essential hypertension.Objective: By answering the questionnaire and experimenting the OGTT, to obtain the epidemiological situation of gluco-metabolic profile in patients with essential hypertension in Shan Dong province and to investigate the rate of the awareness of DM; to analyze the change trend with the increasing of age and its risk factors; to explore the pathogenesis and to provide a basis for early intervention to prevent cardiovascular and cerebrovascular complications.Methods: Screening of the 1,368 cases with hypertension in the investigation of diabetes and metabolic syndrome prevalence rate in Shandong Province . Investigation included the name, age, sex, dietary status, smoking history, alcohol history, family history, history of cardiovascular disease, history of hypertension, diabetes and drug use history; and at the same time measuring the following indicators , including blood pressure, height , weight, waist circumference, hip circumference, body fat content and so on. Exclusion of patients with having known diabetes, for the remainder cases with hypertension, experimenting the OGTT and giving intravenous lipid determination. Epidata 3. 0 software was used to establish the database. SPSS13. 0 software was used for statistical analysis. inter-group analysis were compared by variance analysis; stepwise logistic regression analysis was used for the multi-factor analysis; continuous variables are reported as mean±standard deviation (±s), a p value less than 0.05 is considered significant.Research Results: There are 347 patients with having known diabetes in 1368 cases, and the rate of awareness is (25. 37%). The remaining 1021 patients of hypertension were experimented oral glucose tolerance test (OGTT), of which the diagnostic criteria of diabetes 325 people (31. 83%), impaired glucose tolerance (IGT) 213 people (20.86%), impaired fasting glucose (IFG) 87 people (8.52%), normal blood sugar for (NGT) 396 people (38. 78%). The total number of abnormal glucose metabolism in 1368 patients with hypertension is 972, a ratio of 71.05%. The incidence of metabolic syndrome (MS) in patients with Essential hypertension complicated by abnormal glucose metabolism is nearly 80%. To group patients by 5-year-old age, the incidence of abnormal glucose metabolism increases with age. Patients were divided into diabetic group (DM), impaired glucose tolerance group (IGR), impaired fasting glucose group (IFG) and normal glucose tolerance (NGT), measurement data one-way ANOVA showed that age, waist circumference, waist-hip ratio, body fat, systolic blood pressure, plasma total cholesterol (TC) have significant difference between four groups. Patients were divided into abnormal glucose metabolism and normal glucose metabolism group, a further logistic regression model used to analyze the risk factors, the results showed that gender, age, waist circumference, systolic blood pressure levels, TC and HDL have its significant impact on glucose metabolism , and they are the independent risk factor for hypertension with abnormal glucose metabolism.Conclusion: The rate of essential hypertension patients with abnormal glucose metabolism is very high, and the present diagnosis rate is very low. Increased with age, the incidence rate increased accordingly. For hypertension patients with abnormal glucose metabolism, the incidence of metabolic syndrome is nearly 80% and the independent risk factors are sex, age, waist circumference, systolic blood pressure levels, TC and HDL. For hypertensive patients, especially elderly patients, glucose and lipid metabolism should be given more attention, and doctors should actively carry out OGTT to early detect and treat the disorders of glucose metabolism, which can be more reduced the incidence of cardiovascular disease and improve the health of the masses quality.