Abstract: AIM:To investigate abnormal glucose metabolism and changes of ambulatory blood pressure in young and middle-aged patients with essential hypertension. METHODS: Fasting plasma glucose (FPG), 2-h glucose (PPG) and 24-h ambulatory blood pressure were monitored in 119 patients with hypertension but without diabetes. According to the results of FPG and PPG, patients were divided into three groups: normal glucose tolerance (group B), impaired glucose regulation (group C) and newly diagnosed type 2 diabetes (group D); 31 subjects with normal blood pressure and normal blood glucose were chosen as normal controls (group A). RESULTS: Average values of 24-h systolic blood pressure, 24-h pulse pressure and morning blood pressure peak all gradually increased from group B to group C and group D (P<0.05 or P<0.01), and the incidences of abnormal blood pressure load, abnormal morning blood pressure peak and non-dipper blood pressure shared the same trend (P<0.05 or P<0.01). Multifactorial linear regression analysis showed that BMI, duration of hypertension, pulse pressure, blood pressure morning peak, circadian rhythms of blood pressure and blood glucose were positively correlated (P<0.05 or P<0.01). CONCLUSION: Young and middle-aged patients with hypertension are prone to abnormal glucose metabolism and combined detection of FPG and PPG contributes to diagnosis of abnormal glucose metabolism.