Abstract: Objective To characterize unknown glucometabolic state in patients with essential hypertension (EHT) and
normotensive patients and determine which EHT patients are candidates for oral glucose tolerance tests (OGTTs). Methods
This cross-sectional study consecutively recruited 895 EHT patients and 486 normotensive patients. The data including blood
glucose, blood pressure, blood lipids, angiography profiles, and left ventricular parameters were collected. Results OGTTs
performed in all patients revealed that the prevalence of abnormal glucose metabolism (AGM) was significantly higher in EHT
patients than in normotensive patients at both baseline (P<0.001) and post-OGTT analysis (P<0.001). In total, 76.4% of the
individuals with impaired glucose tolerance and 78.2% of individuals with newly diagnosed diabetes would have remained
undetected if OGTTs had not been performed. Newly diagnosed AGM was significantly correlated with the presence and
severity of coronary stenosis and left ventricular structure abnormalities and dysfunction. EHT patients with fasting glucose ≥ 5.6 mmol/L, hypertension duration exceeding 10 years, coronary artery disease, high-sensitivity C-reactive protein >3 mg/L, or
high levels of apoB/apoA-1 ratio were at high risk of AGM. Conclusions AGM is more common in patients with EHT than in
normotensive patients, and OGTTs is a cost-effective strategy to detect AGM in EHT patients.