Diagnosing Abnormal Glucose Tolerance in Hypertensive Women: Are We Making the Best Choice?

Essential hypertension is a condition of peripheral insulin resistance; thus, fasting plasma glucose level (FPG) alone may not identify glucose tolerance abnormalities. To evaluate the value of an FPG of 100 mg/dL in the detection of these abnormalities in hypertensive women and to identify clinical markers of a high risk of glucose intolerance indicative of further investigation, the authors studied 313 hypertensive women, without known diabetes, in whom an oral glucose tolerance test (OGTT) was performed. The authors demonstrated that FPG alone was not sufficient to identify 27.6% of hypertensive women with glucose intolerance. In this subgroup, the association of waist circumference ≥97 cm and FPG ≥100 mg/dL increased the risk of glucose intolerance with an odds ratio of 6.97. The authors suggest that OGTT should be performed in hypertensive women with normal FPG but with FPG ≥90 mg/dL or waist circumference ≥97 cm.