The influence of blood pressure and carbohydrate tolerance on vascular compliance in humans.

We conducted noninvasive measures of vascular compliance and glucose tolerance in 275 normotensive and hypertensive subjects. Of the total, 194 (70.5%) were hypertensive, 73 (26%) diabetic, 7 (2.5%) normotensive and diabetic and 66 (24%) both hypertensive and diabetic, and 74 (27%) normotensive and nondiabetic. In addition, 57 of the nondiabetic subjects had impaired glucose tolerance based on the results of blood glucose levels 2 h after a glucose challenge. For the entire population, large artery compliance was correlated with systolic (P < .001), diastolic (P = .041), and pulse (P < .001) pressures, whereas small artery compliance correlated significantly (P < .001) only with systolic and pulse pressures. Among hypertensives, a significant decrease in large and small vessel compliance was seen, which was reduced further in the case of small vessel compliance by the presence of diabetes. When the population was separated on the basis of glucose tolerance into normal, impaired, and diabetic groups, a progressive reduction (P < .001) in small artery compliance was seen that was independent of age. Similar significant (P < .001) progressive increases in body mass index and systolic pressure were seen with progression of carbohydrate intolerance. These findings confirm the close relationship between elevated blood pressure (BP) and carbohydrate intolerance and indicate that the vascular effects of both are separate, additive, and primarily on small blood vessel compliance. These findings have important implications for the preclinical detection and potential prevention of hypertension, diabetes, and associated vascular disease.