Pulse pressure, mean blood pressure and impaired glucose tolerance--a study in middle-aged subjects.

In a study of 695 middle-aged subjects, without antihypertensive agents, and without more pronounced obesity, both pulse pressure (PP) and mean blood pressure (MBP) were strongly related to 2-h blood glucose in 75 g OGTTs (p < 0.001). All hypertensives (DBP > or = 90 mm Hg) were separated into 39 with higher PP (> or = 60 mm Hg) and 137 with lower PP (< 60 mm Hg). The high PP hypertensives, compared with the low PP hypertensives and all 519 normotensives, had higher frequency of impaired glucose tolerance (IGT; WHO-criteria), 33%, 6%, and 4%, respectively (p < 0.001), and also higher mean 2-h blood glucose, 5.9, 4.5, and 4.2 mmol.l-1, respectively (p < 0.001). These differences were independent of MBP levels. Similarly, all 54 hypertensives with higher MBP (> or = 110 mm Hg) had more IGT and higher 2-h glucose than the 122 hypertensives with lower MBP (< 110 mm Hg) or the normotensives, 30%, 5% and 4%, respectively (p < 0.001), and 5.8, 4.4, 4.2 mmol.l-1, respectively (p < 0.001), independently of PP. Thus, both high PP and high MBP were related to IGT, independently of each other.