The relationship of arterial hypertension with the disturbance of glucose tolerance

Abstract

Arterial hypertension and impaired glucose tolerance are in many ways interdependent and often precede a more pronounced pathology, the metabolic syndrome. In this regard, it is an actual problem of modern medicine, as the timely diagnosis and treatment of this combination can reduce the disability and mortality in this cohort of patients, prolonging their life and preserving their working capacity. Clinical features of hypertension with concomitant metabolic disorders are: frequent formation of refractory hypertension, early damage to target organs-development of LVH (left ventricular hypertrophy), quickly leading to myocardial dysfunction, renal hyper filtration and MAU, reduction of aortic and arteries elasticity. It has been established that impairment of insulin's ability to suppress glucose production in the liver and/or stimulate glucose uptake by peripheral tissues can underlie a decrease in insulin sensitivity. Since in healthy people 75–80% of glucose is utilized by skeletal muscles, it is more likely that its main cause of IR is impaired insulin stimulated glucose utilization [8]. A certain value in the development of hypertrophy and proliferation of smooth muscle cells and fibroblasts of the vascular wall in hypertension has a stimulating effect of insulin on collagen synthesis. It has been established that the thickness of the intima media complex of the carotid artery and the number of desquamated endotheliocytes circulating in the blood of patients with hypertension with IGT closely correlate with elevated insulin levels [5]. Thus, hypertension and IGT are largely interdependent conditions, significantly affect health and often precede a more pronounced pathology-the metabolic syndrome. Timely diagnosis and correction of this combination can reduce disability and premature death, prolong and improve their quality of life, and maintain their efficiency.