Carotid Intima Media Thickness in Nondiabetic Hypertensive Nigerians: Role of Fasting and Postprandial Blood Glucose.

B N Okeahialam,H O Kolade-Yunusa,S A Muoneme

doi:10.1155/2016/1429451

B N Okeahialam, H O Kolade-Yunusa + Show 1 more

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https://doi.org/10.1155/2016/1429451

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Abstract

Background/Aims. Carotid intima media thickness (CIMT) tracks atherosclerotic vascular disease. Hypertension and diabetes chiefly contribute to atherosclerosis with 75% of symptomatic cardiovascular disease cases having dysglycaemia even in normal cases. Hypothesising that postprandial hyperglycaemia contributes to cardiovascular morbidity, we sought to determine if any relationship existed between glycaemic profile in nondiabetic hypertensives and atherosclerosis. Methods. In a study of CIMT in nondiabetic, statin-naïve hypertensives, we evaluated fasting blood glucose (FBG) and 2-hour postprandial sugar (2hPPBG) in the patients and compared them with the CIMT. CIMT was measured on both sides, 1 cm proximal to the carotid bulb using a 7.5 mHz transducer of ALOKA SSD-3500 ultrasound machine. Results. The subjects with complete data were 86 (63 F). The mean (SD) of CIMT was 0.89 (0.15) mm, FBG 4.8 (0.097) mmol/L, and 2hPPBG 6.5 (1.81) mmol/L. There was no significant correlation between FBG and 2hPPBG with CIMT. Blood pressure had no bearing on this. When blood glucose data were divided into quartiles and post hoc multiple comparison was done, there was significant difference in CIMT for the different ranges. This was not so for 2hPPBG. Conclusion. Though expected from other studies, we did not show any significant correlation between FBG and 2hPPBG status and CIMT. This may be our pattern as the degree of excursion of 2hPPBG was low. There may be a threshold level above which PPBG starts to impact CIMT.

Highlights

Carotid intima media thickness (CIMT) has been shown to have a relationship with atherosclerotic vascular events in various vascular beds [1]
In an earlier study in our centre, we showed that fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2hPPBG) contribute significantly to cardiovascular disease burden in Nigerian Africans with diabetes mellitus [8]
We have shown that, in nondiabetic hypertensives, both FBG and 2hPPBG have no significant bearing on CIMT

Summary

Introduction

Carotid intima media thickness (CIMT) has been shown to have a relationship with atherosclerotic vascular events in various vascular beds [1]. Several risk factors contribute to atherosclerosis with hypertension and diabetes as chief contributors [3]. Accumulating evidence suggests that about 75% of symptomatic cardiovascular disease patients have dysglycaemia [4]. This is not detected by increase in fasting or postprandial blood sugar; the latter is even seen to be of greater impact [5]. Postprandial hyperglycaemia but not fasting hyperglycaemia has been shown to independently predict the occurrence of cardiovascular events [6]. Even in patients with normal glucose metabolism, postload glycaemia correlates with the risk of cardiovascular and noncardiovascular deaths [7]

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