Abnormal glucose tolerance and hypertension

To quantify the association of abnormal glucose tolerance with hypertension and postural hypotension, 2480 men and women aged 50-89 yr from a defined population were evaluated by oral glucose tolerance and measurements of supine, seated, and standing blood pressure. In both sexes, adults with impaired glucose tolerance or non-insulin-dependent diabetes mellitus (NIDDM) had increased mean blood pressure compared with those with normal glucose tolerance. These differences were both statistically (P < 0.05) and clinically (3-12 mmHg) significant and were independent of age, obesity, and the use of antihypertensive medication. Age-adjusted rates of systolic hypertension and isolated systolic hypertension were also higher in subjects with impaired glucose tolerance or NIDDM compared with those with normal glucose tolerance. Diastolic blood pressures and rates of diastolic hypertension were minimally higher in adults with impaired glucose tolerance and NIDDM. In both sexes, systolic blood pressure correlated significantly with fasting plasma glucose and 2-h postchallenge plasma glucose even after adjustment for age and obesity. Postural hypotension occurred in 7% of all subjects and did not vary significantly according to glucose tolerance.