Short-term metabolic changes achieved by weight loss in hypertensive patients.
BACKGROUND
Glucose and lipid metabolism abnormalities of hypertensive patients are highly relevant due to its increase in cardiovascular risk; moreover, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) have a high risk of new-onset diabetes mellitus (DM) development. The objective of the study was to describe glucose metabolism abnormalities and the impact of mid-term weight loss.


METHODS
A six-month prospective, observational and multicentre study of patients with hypertension was conducted. Clinical antecedents, physical examination, blood test and treatments were collected in two separated visits; conventional advice was the only intervention planned.


RESULTS
A total of 1957 patients were included, mean age 66.3 (10.9) years and 59.9% males. A previous diagnosis of glucose metabolism alteration was present in 43.9% (25.5% type-2 DM, 14.8% IFG, 1.6% IFG and IGT, 1.0% IGT and 1.0% type-1 DM). An increasing pattern of cardiovascular risk and target organ damage was observed according to the categories of fasting glucose. Oral glucose tolerance test (OGTT) was carried out in 234 patients (11.9%) patients and yielded the diagnosis of IGT in 44.7% or DM in 22.4% of patients with fasting glucose >100mg/dl. Six months follow-up was achieved in 85.9% patients. A slight reduction in fasting glucose was observed in the whole cohort and patients who achieved ≥ 5% weight loss experienced the highest reduction in fasting glucose, LDL-c and triglycerides; moreover, 15.8% normalized their IFG.


CONCLUSIONS
Glucose and lipid metabolism abnormalities are highly prevalent in hypertensive patients and improve with 5% of weight lost at 6 months follow-up. OGTT is not currently extended in daily clinical practise.
Cordero
Alberto
A
Hospital Universitario de San Juan, Alicante, Spain. acordero@coma.es
Bertomeu-Martínez
Vicente
V
Mazón
Pilar
P
Martín-Raymondi
Diego
D
Palma
Jose Luis
JL
Anguita
Manuel
M
Lekuona
Iñaki
I
Galve
Enrique
E
González-Juanatey
José R
JR
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D050356:Lipid Metabolism / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology*
D001786:Blood Glucose