1-h Postload PlasmaGlucose Levels and Left Ventricular Mass in Hypertensive Patients

OBJECTIVE—Left ventricular hypertrophy (LVH), an independent risk factor for cardiovas-cular (CV) morbidity and mortality, recognizes a multifactorial pathogenesis. A plasma glucose value $155 mg/dL for the 1-h postload plasma glucose during an oral glucose tolerance test (OGTT) identifies subjects with normal glucose tolerance (NGT) at high risk for type 2 diabetes. We addressed the question if glucose tolerance status, particularly 1-h postload plasma glucose levels, affects left ventricular mass (LVM) and cardiac geometry in essential hypertension. RESEARCH DESIGN AND METHODS—We enrolled 767 never-treated hypertensive subjects, 393 women and 374 men (mean age 49.6 6 8.5 years). All patients underwent an OGTT for the evaluation of glucose tolerance and standard echocardiography. LVM was calcu-lated using the Devereux formula and normalized by body surface area (LVM index [LVMI]). Insulin sensitivity was assessed by theMatsuda index. Among all participants, 514 hadNGT, 168 had impaired glucose tolerance (IGT), and 85 had type 2 diabetes. According to the 1-h postload plasma glucose cutoff point of 155 mg/dL, we divided normotolerant subjects into two groups: NGT,155 mg/dL (n = 356) and NGT $155 mg/dL (n = 158). RESULTS—Subjects in the NGT $155 mg/dL group had worse insulin sensitivity than sub