| Objective: Abnormal glucose metabolism often occurs in essentialhypertension. The incidence of abnormal glucose metabolism in hypertensionis up to70%(including diabetes, Impaired Glucose Tolerance and Impairedfasting glucose),and on the other hand, the incidence is nearly50%. Alongwith hypertension, diabetes is a risk factor of CHD, and the two have aproduct effect. When the two coexist, not only the treatment is difficult, butalso the incidence of cardiovascular events will greatly increase. The purposeof this study is to improve the clinicians, concern about abnormal glucosemetabolism in hypertension through this survey. All these will help us toperform clinical work.Methods: The patients of essential hypertension admitted to the secondhospital of Hebei Medical University from July2010to June2011werecollected. Investigation included the age, gender, blood pressure level, types ofantihypertensive drugs (calcium channel blocker(CCB), angiotensin con-verting enzyme inhibitor(ACEI), angiotensin receptor blocker(ARB), diuretics,β-blockers, α-blockers), disease (CHD, IFG, IGT, diabetes, stroke). Statisticsthe numbers of patients determining FPG, PPG, HbA1c, OGTT, with abnormalPPG but normal FPG, diagnosed with abnormal glucose metabolism (DM, IGT,IFG).Statistical analysis: Count data expressed in percentage terms betweenthe two groups applied chi-square test. If the difference was significant whencomparing the rate of the cognition in more than two groups of one team, wecompared the cognition rate every two groups in the team (Level of the testα'=α/the number of comparison). All statistical analysis were done onSPSS13.0software.Results:①T he rates of determining FBG,2hPG, HbA1c and OGTT were 80.9%,26.3%,31.7%,0.5%among the733patients.②T herewere571patients who were not diagnosed as abnormal glucose metabolism, and therates of FBG,2hPG, HbA1c and OGTT were respectively79.5%,16.6%,26.6%and0.5%. At the same time, there were162patients who werediagnosed as IFG, IGT or diabetes, and the rates were85.8%,59.9%,49.6%and0.6%. The latter rates of PPG (χ~2=122.042, P=0.000) and HbA1c(χ~2=30.226, P=0.000) were higher than the former, and others had nosignificance for difference.③There were12.9%with abnormal PPG inpatients with normal FPG.④I n hypertension stage1,2and3, the rates ofdetermining FBG were83.0%,86.9%and8.2%. The rate of stage2washigher than3, and the others had no significance for difference. The rates ofPPG were18.9%,30.0%,25.5%. And the rates of HbA1c were20.8%,34.8%,31.5%. All these had no significance for difference. The rates of OGTT are0,0,0.8%.⑤There were263(35.9%) hypertension patients with abnormalglucose metabolism, including101(38.4%) newly diagnosed ones. The ratesof IFG, IGT, IFG+IGT, and diabetes were3.4%,6.8%,1.1%, and88.6%.Moreover,93.2%of hypertension with abnormal glucose metabolism sufferedfrom CHD,22.0%of which were myocardial infarction, and12.5%sufferedfrom stroke.⑥Among all patients, the rates ofapplication of ACEI, ARB,CCB, β-blocker, α-blocker and diuretics were33.3%,38.2%,50.3%,70.3%,0.1%, and23.2%. However, the rates in hypertension with abnormal glucosemetabolism were33.5%,40.3%,57.0%,71.9%,0.4%, and20.2%. In latter,there were respectively12.9%and6.1%who used ACEI+CCB and ACEI+diuretics. And the rates of using ARB+CCB and ARB+diuretics were26.2%and11.0%.Conclusion: The prevalence rate of hypertension with abnormal glucosemetabolism is high, but the rate of attention is very low. At the same time,hypertension is easily associated with cardiovascular and cerebrovasculardiseases. The clinicians are increasingly concerned about blood glucose, butthe gap between clinical and guidelines is still large. So the attention about PPG, OGTT, and HbA1c needs to be strengthened. |
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