Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Advertisement

Hypertension Research
  • View all journals
  • Search
  • Log in
  • Content Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • RSS feed
  1. nature
  2. hypertension research
  3. original article
  4. article
Postchallenge Plasma Glucose and Glycemic Spikes Are Associated with Pulse Pressure in Patients with Impaired Glucose Tolerance and Essential Hypertension
Download PDF
Download PDF
  • Original Article
  • Published: 01 August 2008

Postchallenge Plasma Glucose and Glycemic Spikes Are Associated with Pulse Pressure in Patients with Impaired Glucose Tolerance and Essential Hypertension

  • Futoshi Anan1,2,
  • Takayuki Masaki1,
  • Takeshi Eto2,
  • Naoya Fukunaga2,
  • Tetsu Iwao2,
  • Koji Kaneda2,
  • Nobuoki Eshima3,
  • Tetsunori Saikawa4 &
  • …
  • Hironobu Yoshimatsu1 

Hypertension Research volume 31, pages 1565–1571 (2008)Cite this article

  • 994 Accesses

  • Metrics details

Abstract

Elevated pulse pressure (PP) is associated with an increased risk of cardiovascular events. We examined whether PP is associated with post-challenge hyperglycemia in Japanese patients with essential hypertension and impaired glucose tolerance (IGT). In a total of 70 untreated essential hypertensive patients (age: 57±4 years, mean±SD; males±35, females=35), 24-h ambulatory blood pressure (ABP) monitoring, 75 g oral glucose tolerance testing (OGTT), metabolic analysis and echocardiography were performed. Patients were categorized into a high PP group (PP≥60 mmHg, n≥33) or a normal PP group (PP<60 mmHg, n=37). In all patients, 24-h systolic ABP, daytime systolic ABP, nighttime systolic ABP, and nighttime heart rate were significantly higher in the high PP group. Additionally, fasting immunoreactive insulin (F-IRI), homeostasis model assessment (HOMA) index, left ventricular mass index (LVMI) were also elevated in the high PP group. Finally, the high PP group exhibited impaired insulin secretion, increased post-challenge glucose concentrations and greater glucose spikes (PGS) during 75 g OGTT. Of the parameters measured, 24-h PP correlated positively with age, triglyceride, uric acid, F-IRI, HOMA index, 1-h postload glucose and insulin, 2-h postload glucose and insulin, PGS60, PGS120, PGSmax, LVMI, and deceleration time but correlated negatively with HDL-cholesterol and E/A ratio. Multiple regression analysis revealed that PP level was independently predicted by age, LVMI, and PGS120. Our results show that age, LVMI, and PGS120 are significantly associated with high PP in Japanese patients with IGT and essential hypertension.

Similar content being viewed by others

Isolated systolic hypertension and insulin resistance assessment tools in young and middle-aged Chinese men with normal fasting glucose: a cross-sectional study

Article Open access 14 January 2022

Postloading insulinemia is independently associated with arterial stiffness in young Japanese persons

Article Open access 13 September 2021

Three-year change in glycemic state and the future risk of incident hypertension among Iranian adults: Tehran Lipid and Glucose Study

Article 06 December 2022

Article PDF

References

  1. Franklin SS, Gustin W 4th, Wong ND, et al: Hemodynamic patterns of age-related changes in blood pressure: the Framingham Heart Study. Circulation 1997; 96: 308–315.

    Article  CAS  PubMed  Google Scholar 

  2. Franklin SS, Khan SA, Wong ND, Larson MG, Levy D : Is pulse pressure useful in predicting coronary heart disease? The Framingham Heart study. Circulation 1999; 100: 354–360.

    Article  CAS  PubMed  Google Scholar 

  3. Benetos A, Safar M, Rudnichi A, et al: Pulse pressure: a predictor of long-term cardiovascular mortality in a French male population. Hypertension 1997; 30: 1410–1415.

    Article  CAS  PubMed  Google Scholar 

  4. Benetos A, Rudnichi A, Safar M, Guize L : Pulse pressure and cardiovascular mortality in normotensive and hypertensive subjects. Hypertension 1998; 32: 560–564.

    Article  CAS  PubMed  Google Scholar 

  5. Fang J, Madhavan S, Alderman MH : Pulse pressure: a predictor of cardiovascular mortality among normotensive subjects. Blood Pressure 2000; 9: 260–266.

    Article  CAS  PubMed  Google Scholar 

  6. Saloman V, Riley W, Kark JD, Nardo C, Folsom AR : Non–insulin-dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes: the ARIC Study. Circulation 1995; 91: 1432–1443.

    Article  Google Scholar 

  7. Schram MT, Henry RM, van Dijk RA, et al: Increased central artery stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn Study. Hypertension 2004; 43: 176–181.

    Article  CAS  PubMed  Google Scholar 

  8. van Dijk RAJM, van Ittersum FJ, Westerhof N, et al: Determinants of brachial artery mean 24–h pulse pressure in individuals with type II diabetes mellitus and untreated mild hypertension. Clin Sci 2002; 102: 177–186.

    Google Scholar 

  9. Laakso M : Hyperglycemia and cardiovascular disease in type 2 diabetes. Diabetes 1999; 48: 937–942.

    Article  CAS  PubMed  Google Scholar 

  10. Lee JW, Lee DC, Im JA, Shim JY, Kim SM, Lee HR : Insulin resistance is associated with arterial stiffness independent of obesity in male adolescent. Hypertens Res 2007; 30: 5–11.

    Article  CAS  PubMed  Google Scholar 

  11. Barrett-Connor E, Ferrara A : Isolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men. The Rancho Bernardo Study. Diabetes Care 1998; 21: 1236–1239.

    Article  CAS  PubMed  Google Scholar 

  12. DECODE Study Group: Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnosis criteria. Arch Intern Med 2001; 161: 397–404.

  13. Tominaga M, Eguchi H, Manaka H, Igarashi K, Kato T, Sekikawa A : Impaired glucose tolerance is a risk fator for cardiovascular disease, but not in impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 1999; 22: 920–924.

    Article  CAS  PubMed  Google Scholar 

  14. Temelkova-Kurktschiev TS, Koehler C, Leonhardt W, Fuecker K, Hanefeld M : Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose and HbA1c level. Diabetes Care 2000; 23: 1830–1834.

    Article  CAS  PubMed  Google Scholar 

  15. Boyko EJ, Fujimoto WY, Leonetti DL, Newell-Morris L : Visceral adiposity and risk of type 2 diabetes: a prospective study among Japanese Americans. Diabetes Care 2000; 23: 465–471.

    Article  CAS  PubMed  Google Scholar 

  16. Pickering TG, Ad Hoc Panel: Recommendations for the use of home (self) and ambulatory blood pressure monitoring. Am J Hypertens 1996; 9: 1–11.

    Article  CAS  PubMed  Google Scholar 

  17. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1997; 20: 1183–1197.

  18. Tochikubo O, Ikeda A, Miyajima E, Ishii M : Effect of insufficient sleep on blood pressure monitored by a new multibiomedical recorder. Hypertension 1996; 27: 1318–1324.

    Article  CAS  PubMed  Google Scholar 

  19. Kohara K, Nishida W, Maguchi M, Hiwada K : Autonomic nervous function in non-dipper essential hypertensive subjects. Evaluation by power spectral analysis of heart rate variability. Hypertension 1995; 26: 808–814.

    Article  CAS  PubMed  Google Scholar 

  20. Devereux RB, Alonso DR, Lutas EM, et al: Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986; 57: 450–458.

    Article  CAS  PubMed  Google Scholar 

  21. Uen S, Baulmann J, Dusing R, Glanzer K, Vetter H, Mengden T : ST-segment depression in hypertensive patients is linked to elevations in blood pressure, pulse pressure and double product by 24-h Cardiotens monitoring. J Hypertens 2003; 21: 977–983.

    Article  CAS  PubMed  Google Scholar 

  22. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC : Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419.

    Article  CAS  PubMed  Google Scholar 

  23. Kanauchi M, Motomiya K, Hashimoto T : Insulin secretion and sensitivity in non-obese and obese Japanese patients with coronary artery disease. Metabolism 2000; 51: 184–188.

    Article  CAS  Google Scholar 

  24. Fukushima M, Usami M, Ikeda M, et al: Insulin secretion and insulin sensitivity at different stages of glucose tolerance: a cross-sectional study Japanese type 2 diabetes. Metabolism 2004; 53: 831–835.

    Article  CAS  PubMed  Google Scholar 

  25. Esposito K, Nappo F, Marfella R, et al: Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 2002; 106: 2067–2072.

    Article  CAS  PubMed  Google Scholar 

  26. Harris TB, Ferrucci L, Tracy RP, et al: Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. Am J Med 1999; 106: 506–512.

    Article  CAS  PubMed  Google Scholar 

  27. Ceriello A, Bortolotti N, Motz E, et al: Meal-generation oxidative stress in type 2 diabetic patients. Diabetes Care 1998; 21: 1529–1533.

    Article  CAS  PubMed  Google Scholar 

  28. Marfella R, Quagliaro L, Nappo F, Ceriello A, Giugliano D : Acute hyperglycemia induces an oxidant stress in healthy subjects. J Clin Invest 2001; 108: 635–636.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Ceriello A, Bortolotti N, Falleti E, et al: Total radical trapping antioxidant parameter in NIDDM patients. Diabetes Care 1997; 20: 194–197.

    Article  CAS  PubMed  Google Scholar 

  30. Tomiyama H, Kimura Y, Okazaki R, et al: Close relationship of abnormal glucose tolerance with endothelial dysfunction in hypertension. Hypertension 2000; 36: 245–249.

    Article  CAS  PubMed  Google Scholar 

  31. Kawano H, Motoyama T, Hirashima O, et al: Hyperglycemia rapidly suppresses flow-mediated endothelium-dependent vasodilation of brachial artery. J Am Coll Cardiol 1999; 34: 146–154.

    Article  CAS  PubMed  Google Scholar 

  32. Heitzer T, Schling T, Krohn K, Meinertz T, Munzel T : Endothelial dysfunction, oxidative stress, and risk of cardiovascular events in patients with coronary artery disease. Circulation 2001; 104: 2673–2678.

    Article  CAS  PubMed  Google Scholar 

  33. Haenni A, Andersson PE, Lind L, Berne C, Lithell H : Electrolyte changes and metabolic effects of lisinopril/bendrofluazide treatment. Results from a randomized, doubleblind study with parallel groups. Am J Hypertens 1994; 7: 615–622.

    Article  CAS  PubMed  Google Scholar 

  34. Risso A, Mercuri F, Quagliaro L, Damante G, Ceriello A : Intermittent high glucose enhances apoptosis in human umbilical vein endothelial cell in culture. Am J Physiol 2001; 281: E924–E930.

    CAS  Google Scholar 

  35. Nakano S, Konishi K, Furuya K, et al: A prognostic role of mean 24-h pulse pressure level for cardiovascular events in type 2 diabetic subjects under 60 years of age. Diabetes Care 2005; 28: 102–107.

    Article  Google Scholar 

  36. Tomiyama H, Yamada J, Koji Y, et al: Heart rate elevation precedes the development of metabolic syndrome in Japanese men: a prospective study. Hypertens Res 2007; 30: 417–426.

    Article  PubMed  Google Scholar 

  37. Anan F, Takahashi N, Ooie T, Yufu K, Saikawa T, Yoshimatsu H : Role of insulin resistance in nondipper essential hypertensive patients. Hypertens Res 2003; 26: 669–676.

    Article  CAS  PubMed  Google Scholar 

  38. Anan F, Yonemochi H, Masaki T, et al: High-densisty lipoprotein cholesterol and insulin resistance are independently and additive markers of left ventricular hypertrophy in essential hypertension. Hypertens Res 2007; 30: 125–131.

    Article  CAS  PubMed  Google Scholar 

  39. Facchini FS, Stoohs RA, Reaven GM : Enhanced sympathetic nervous system activity. Am J Hypertens 1995; 9: 1013–1017.

    Article  Google Scholar 

  40. Khatter RS, Acharya DU, Kinsey C, Senoir R, Lahiri A : Longitudinal association of ambulatory pulse pressure with left ventricular mass and vascular hypertrophy in essential hypertension. J Hypertens 1997; 15: 737–743.

    Article  Google Scholar 

  41. Jokiniitty JM, Majahalme SK, Kahonen MA, et al: Pulse pressure is the best predictor of future left ventricular mass and change in left ventricular mass: 10 years of follow up. J Hypertens 2001; 19: 2047–2054.

    Article  CAS  PubMed  Google Scholar 

  42. Tarazi RC : The role of the heart in hypertension. Clin Sci 1982; 63: 347S–365S.

    Article  Google Scholar 

  43. Ceravolo R, Maio R, Pujia A, et al; Pulse pressure and endothelial dysfunction in never-treated hypertensive patients. J Am Coll Cardiol 2003; 41: 1753–1758.

    Article  CAS  PubMed  Google Scholar 

  44. Girerd X, Laurent S, Pannier B, Asmar R, Safar M : Arterial distensibility and left ventricular hypertrophy in patients with sustained essential hypertension. Am Heart J 1991; 122: 1210–1214.

    Article  CAS  PubMed  Google Scholar 

  45. Tanaka M, Babazono T, Takeda M, Iwamoto Y : Pulse pressure and chronic kidney disease in patients with type 2 diabtes. Hypertens Res 2006; 29: 345–352.

    Article  PubMed  Google Scholar 

  46. Takahashi N, Anan F, Nakagawa M, et al: Microalbuminuria, cardiovascular dysfunction, and insulin resistance in patients with type 2 diabetic patients. Metabolism 2004; 53: 1359–1364.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. First Department of Internal Medicine, Oita University, Oita, Japan

    Futoshi Anan, Takayuki Masaki & Hironobu Yoshimatsu

  2. Department of Cardiology, Oita Red Cross Hospital, Oita, Japan

    Futoshi Anan, Takeshi Eto, Naoya Fukunaga, Tetsu Iwao & Koji Kaneda

  3. Department of Biostatistics, Oita University, Oita, Japan

    Nobuoki Eshima

  4. Department of Cardiovascular Science, Faculty of Medicine, Oita University, Oita, Japan

    Tetsunori Saikawa

Authors
  1. Futoshi Anan
    View author publications

    Search author on:PubMed Google Scholar

  2. Takayuki Masaki
    View author publications

    Search author on:PubMed Google Scholar

  3. Takeshi Eto
    View author publications

    Search author on:PubMed Google Scholar

  4. Naoya Fukunaga
    View author publications

    Search author on:PubMed Google Scholar

  5. Tetsu Iwao
    View author publications

    Search author on:PubMed Google Scholar

  6. Koji Kaneda
    View author publications

    Search author on:PubMed Google Scholar

  7. Nobuoki Eshima
    View author publications

    Search author on:PubMed Google Scholar

  8. Tetsunori Saikawa
    View author publications

    Search author on:PubMed Google Scholar

  9. Hironobu Yoshimatsu
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Futoshi Anan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Anan, F., Masaki, T., Eto, T. et al. Postchallenge Plasma Glucose and Glycemic Spikes Are Associated with Pulse Pressure in Patients with Impaired Glucose Tolerance and Essential Hypertension. Hypertens Res 31, 1565–1571 (2008). https://doi.org/10.1291/hypres.31.1565

Download citation

  • Received: 16 May 2007

  • Accepted: 02 May 2008

  • Issue date: 01 August 2008

  • DOI: https://doi.org/10.1291/hypres.31.1565

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Keywords

  • pulse pressure
  • left ventricular mass index
  • post-challenge glucose spikes
  • impaired glucose tolerance
  • essential hypertension

This article is cited by

  • Positive association between baseline brachial–ankle pulse wave velocity and the risk of new-onset diabetes in hypertensive patients

    • Yuanyuan Zhang
    • Panpan He
    • Xianhui Qin

    Cardiovascular Diabetology (2019)

Download PDF

Advertisement

Explore content

  • Research articles
  • Reviews & Analysis
  • News & Comment
  • Current issue
  • Collections
  • Sign up for alerts
  • RSS feed

About the journal

  • Journal Information
  • Open Access Fees and Funding
  • Guide to Authors
  • About the Editors
  • Message from Editors
  • Call for Paper
  • Contact
  • About the Partner
  • For Advertisers
  • Subscribe
  • Showcase of Graphical Abstracts on Hypertension Research

Publish with us

  • For Authors & Referees
  • Language editing services
  • Open access funding
  • Submit manuscript

Search

Advanced search

Quick links

  • Explore articles by subject
  • Find a job
  • Guide to authors
  • Editorial policies

Hypertension Research (Hypertens Res)

ISSN 1348-4214 (online)

ISSN 0916-9636 (print)

nature.com sitemap

About Nature Portfolio

  • About us
  • Press releases
  • Press office
  • Contact us

Discover content

  • Journals A-Z
  • Articles by subject
  • protocols.io
  • Nature Index

Publishing policies

  • Nature portfolio policies
  • Open access

Author & Researcher services

  • Reprints & permissions
  • Research data
  • Language editing
  • Scientific editing
  • Nature Masterclasses
  • Research Solutions

Libraries & institutions

  • Librarian service & tools
  • Librarian portal
  • Open research
  • Recommend to library

Advertising & partnerships

  • Advertising
  • Partnerships & Services
  • Media kits
  • Branded content

Professional development

  • Nature Awards
  • Nature Careers
  • Nature Conferences

Regional websites

  • Nature Africa
  • Nature China
  • Nature India
  • Nature Japan
  • Nature Middle East
  • Privacy Policy
  • Use of cookies
  • Legal notice
  • Accessibility statement
  • Terms & Conditions
  • Your US state privacy rights
Springer Nature

© 2025 Springer Nature Limited