Some features of cardiovascular and metabolic status in young males with prehypertension depending on the level of early post-load glycemia

Objective. To assess the screening prognostic indicators of cardiovascular system, basic types of metabolism in young males with prehypertension, depending on the values of glucose 1‑hour after glucose load in standard oral glucose tolerance test (OGTT).

Design and methods. The study included 105 patients with prehypertension who had fasting euglycemia, normal glucose tolerance and did not suffer from cardiovascular or other clinically relevant internal diseases. Based on the results of OGTT study participants were divided into two groups according to plasma glucose level 1‑hour after glucose load. The 1st group included 58 patients with one hour post-load glucose level < 8,6 mmol/L (mean age 38 ± 5 years). The 2nd group included 47 patients with one hour post-load glucose level ≥ 8,6 mmol/L (mean age 39 ± 5 years). The groups were matched by gender, age, body mass index, office blood pressure. Hemodynamic, electrocardiographic, echocardiographic and laboratory biochemical parameters were evaluated. The obtained data were processed using Statistica for Windows (version 10.0). Student t‑test and Pearson correlation were applied (criterion χ 2).

Results. We found significant differences in serum uric acid levels (p = 0,005) and the ratio apolipoprotein B / apolipoprotein A1 (apoB/apoA1, p = 0,04) between groups 1 and 2.

Conclusions. Young males with early post-load hyperglycemia and prehypertension are characterized by unfavorable lipid and purine metabolism changes in the absence of structural-functional cardiovascular alterations.

1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. J Am Med Assoc. 2003;289 (19):2560–2572.

2. Wang Y, Wang QJ. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem.Arch Intern Med. 2004;164(19):2126–2134.

3. Anand Chockalingam AB. Patterns and predictors of prehypertension among Healthy urban adults in India. Angiology. 2005;56(5):557–563.

4. Yadav S. Prevalence and risk factors of prehypertension and hypertension in an affluent north Indian population. Indian J Med Res. 2008;128(6):712–720.

5. Agyemang C, Owusu-Dubus E. Prehypertension in the Ashanti region of Ghana, West Africa: an opportunity for early prevention of clinical hypertension. Public Health. 2008;122 (1);19–24.

6. Isezuo SA, Sabir AA, Ohwovoriole AE, Fasanmade OA. Prevalence, associated factors and relationship between prehypertension and hypertension: a study of two ethnic African populations in Northern Nigeria. J Hum Hypertens. 2011;25 (4):224–230.

7. Gupta P, Nagarajau SP, Gupta A, Chikkalingaiah KBM. Prehypertension — time to act. Saudi J Kidney Dis Transpl. 2012;23(2):223–233.

8. Succurro E, Marini MA, Arturi F, Grembiale A, Lugarà M, Andreozzi F et al. Elevated one-hour post-load plasma glucose levels identifies subjects with normal glucose tolerance but arly carotid atherosclerosis. Atherosclerosis. 2009;207(1):245–249.

9. Niijima K, Muranaka Y, Ando T, Okada S, Niijima Y, Hashimoto K et al. Elevated 1‑h plasma glucose following 75‑g oral glucose load is a predictor of arterial stiffness in subjects with normal glucose tolerance. Diabet Med. 2012;29(12):457–460.

10. Sciacqua A, Maio R, Miceli S, Pascale A, Carullo G, Grillo N et al. Association between one-hour post-load plasma glucose levels and vascular stiffness in essential hypertension. PLoS One. 2012;7(9):44470.

11. Bianchi C, Miccoli R, Trombetta M, Giorgino F, Frontoni S, Faloia E et al. Elevated 1‑hour postload plasma glucose levels identify subjects with normal glucose tolerance but impaired beta-cell function, insulin resistance, and worse cardiovascular risk profile: the GENFIEV study. J Clin Endocrinol Metab. 2013;98 (5):2100–2105. doi: 10.1210/jc.2012–3971

12. Abdul-Ghani MA, Abdul-Ghani T, Ali N, Defronzo RA. One-hour plasma glucose concentration and the metabolic syndrome identify subjects at high risk for future type 2 diabetes. Diabetes Care. 2008;31(8):650–655.

13. Abdul-Ghani MА, Lyssenko V, Tuomi T, DeFronzo RA, Groop L. Fasting versus postload plasma glucose concentration and the risk for future type 2 diabetes: results from the Botnia Study. Diabetes Care. 2009;32(2):281–286.

14. Sciacqua A, Micel S, Carullo G, Greco L, Succurro E, Arturi F et al. One-hour postload plasma glucose levels and left ventricular mass in hypertensive patients. Diabetes Care. 2011;34(6):1406–1411.

15. Strandberg TE, Pienimäki T, Strandberg AY, Salomaa VV, Pitkälä KH, Tilvis RS et al. One-hour glucose, mortality, and risk of diabetes: a 44‑year prospective study in men. Arch Intern Med. 2011;171(10):941–954.

16. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a World Health Organization/International Diabetes Federation consultation. WHO Document Production Services, Geneva, Switzerland; 2006. 46 р.

17. Кухарчук В. В., Коновалов Г. А., Сусеков А. В., Сергиенко И. В., Семенова А. Е., Горнякова Н. Б. и др. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза (Российские рекомендации, V пересмотр). М., 2012. 50 c. [Kukharchuk VV, Konovalov GA, Susekov AV, Sergienko IV, Semenova AE, Gornyakova NB et al. Diagnosis and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis (Russian recommendations, V revision). Moscow, 2012. 50 p. In Russian].

18. De Marco M, de Simone G, Roman MJ, Chinali M, Lee ET, Russell M et al. Cardiovascular and metabolic predictors of progression of prehypertension into hypertension: the Strong Heart Study. Hypertension. 2009;54(5):974–980.

19. Конради А. О. Молодой и пожилой пациент с артериальной гипертензией: особенности лечения. Артериальная гипертензия. 2014;20(5):406–14. [Konradi AO. Young and elderly patient with hypertension: peculiarities of treatment. Arterial hypertension = Arterial’naya Gipertenziya. 2014;20(5):406–414. In Russian].

20. Барсуков А. В. Состояние сердечно-сосудистой и нейрогуморальной регуляторной систем у лиц молодого возраста с различной степенью стабильности гипертензионного синдрома: Автореф. дис. докт. мед. наук. СПб, 2001. 48 c. [Barsukov AV. Condition of the cardiovascular and neurohumoral regulatory systems in persons of young age with varying degrees of hypertensive syndrome stability: Authoref. dissertation of doctor of medical sciences. St Petersburg, 2001. 48 p. In Russian].

21. Барсуков А. В., Горячева А. А. Изменение состояния вегетативной нервной регуляции ритма сердца в зависимости от длительности артериальной гипертонии. Вестник Российской Военно-медицинской академии. 2005;1 (Приложение):75. [Barsukov AV, Goryacheva AA. Changing of heart rhythm autonomic nervous regulation state depending on the duration of arterial hypertension. Bulletin of the Russian Military Medical Academy. 2005;1(Suppl.):75. In Russian].

22. Чурина С. К., Кузнецов С. Р., Янушкене Т. С., Рыжов Д. В., Клюева Н. З. и др. К патогенезу артериальной гипертензии при дефиците кальция в питьевой воде. Артериальная гипертензия. 1995;1(1):25–30. [Tchurina SK, Kuznetsov SR, Yanushkene TS, Ryzhov DV, Klyueva NZ et al. Calcium deficiency in drinking water and arterial hypertension. Arterial'naya Gipertenziya = Arterial Hypertension. 1995;1(1):25–30. In Russian].

23. Ishikawa Y, Ishikawa J, Ishikawa S et al. Prevalence and determinants of prehypertension in a Japanese general population: the Jichi Medical School Cohort Study. Hypertens Res. 2008;31 (7):323–330.

24. Sciacqua A, Perticone M, Grillo N, Falbo T, Bencardino G, Angotti E et al. Vitamin D and 1‑hour post-load plasma glucose in hypertensive patients. Cardiovascular Diabetology. 2014;13:48–56. doi: 10.1186/1475–2840–13–48.

25. Oh TJ, Min SH, Ahn CH, Kim EK, Kwak SH, Jung HS et al. Normal glucose tolerance with a high 1‑hour postload plasma glucose level exhibits decreased β-cell function similar to impaired glucose tolerance. Diabetes Metab J. 2015;39(2):147–153. doi: 10.4093/dmj.2015.39.2.147.

26. Shimodaira M, Niwa T, Nakajima K, Kobayashi M, Hanyu N, Nakayama T. Correlation between serum lipids and 1‑hour postload plasma glucose levels in normoglycemic individuals. Diabetes Metab J. 2014;38(4):294–301.

27. Sesti G, Hribal M, Fiorentino T, Sciacqua A, Perticone F. Elevated 1 h postload plasma glucose levels identify adults with normal glucose tolerance but increased risk of nonalcoholic fatty liver disease. Br Med J Open Diabetes Research and Care. 2014;2(1): e000016. doi: 10.1136/bmjdrc‑2014–000016.

28. Perticone F, Sciacqua S, Perticone M, Arturi F, Scarpino PE, Quero M et al. Serum uric acid and 1‑h postload glucose in essential hypertension. Diabetes Care. 2012;35(1):153–157.

29. Markus MR, Stritzke J, Lieb W, Mayer B, Luchner A, Döring A et al. Implications of persistent prehypertension for ageing-related changes in left ventricular geometry and function: the MONICA/KORA Augsburg study. J Hypertens. 2008;26 (10):2040–2049.

30. Norton GR, Maseko M, Libhaber E, Libhaber CD, Majane OH, Dessein P et al. Is prehypertension an independent predictor of target organ changes in young-to-middle aged persons of African descent? J Hypertens. 2008;26(12):2279–2287.

31. Dogru MT, Guneri M, Tireli E, Sahin O, Celik T, Iyisoy A. QT interval and dispersion differences between normal and prehypertensive patients: effects of autonomic and left ventricular functional changes. Anadolu Kardiyol Derg. 2009;9(1):15–22.

32. Stabouli S, Kotsis V, Rizos Z, Toumanidis S, Karagianni C, Constantopoulos A et al. Left ventricular mass in normotensive, prehypertensive and hypertensive children and adolescents. Pediatr Nephrol. 2009;24(8):1545–1551.

33. Abdal-Barr MG, Safwat M, Nammas W. Would corrected QT dispersion predict left ventricular hypertrophy in hypertensive patients? Blood Press. 2012;21(4):249–254.

34. Tenekecioglu E, Yilmaz M, Yontar OC, Karaagac K, Agca FV, Tutuncu A Microalbuminuria in untreated prehypertension and hypertension without diabetes. Int J Clin Exp Med. 2014;7 (10):3420–3429.