PS-P11-4: ASSOCIATION OF HOME AND OFFICE SYSTOLIC AND DIASTOLIC HYPERTENSION WITH GLUCOSE METABOLISM IN A GENERAL POPULATION

Abstract

Objective: The aim of this study was to investigate the association of hypertension subtypes with glucose metabolism among the general population. Methods: The study involved 646 residents (mean age: 62.4 years) without treatment for hypertension or a history of diabetes from a rural community, who underwent an oral glucose tolerance test from 1997 to 2019. Hypertension subtypes [normotension (NT), isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH)] were defined based on home and office systolic and diastolic blood pressure (HBP and OBP, respectively). The estimated means of blood glucose levels during OGTT, homeostasis model assessment (HOMA)-insulin resistance (IR), Matsuda-DeFronzo index, HOMA-beta and insulinogenic index among the groups were compared by analysis of covariance adjusted for possible confounding factors. Results: BG-related indices were not different among the morning HBP-defined hypertension subtypes. Participants with evening HBP-defined ISH had a significantly higher estimated mean BG at 120 min, higher homeostasis model assessment-insulin resistance (HOMA-IR), and lower Matsuda-DeFronzo index than participants with NT (the adjusted mean: 146 vs 127 mg/dl, 1.3 vs 1.0, and 6.6 vs 8.1, respectively) (all p < 0.021). Participants with OBP-defined SDH had a significantly higher estimated mean fasting BG; BG at 30, 60, and 120 min; and HOMA-IR and a lower Matsuda-DeFronzo index than participants with NT (the adjusted mean: 101 vs 94 mg/dl, 177 vs 158 mg/dl, 182 vs 157 mg/dl, 145 vs 125 mg/dl, 1.3 vs 1.0, and 6.3 vs 8.3, respectively) (all p < 0.0025). Conclusion: The BG-related indices were different among hypertension subtypes. Participants with evening HBP-defined ISH and OBP-defined SDH had higher BG levels and insulin resistance than participants with correspondingly defined NT, while those with morning HBP did not. These findings suggest the importance of measuring evening HBP and OBP for early detection of coexisting hypertension and diabetes.