Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2016 Aug 20;5(8):e003917.
doi: 10.1161/JAHA.116.003917.

Different Combinations of Glucose Tolerance and Blood Pressure Status and Incident Diabetes, Hypertension, and Chronic Kidney Disease

Arash Derakhshan  1 , Farideh Bagherzadeh-Khiabani  1 , Banafsheh Arshi  1 , Azra Ramezankhani  1 , Fereidoun Azizi  2 , Farzad Hadaegh  3
Affiliations
Observational Study

Different Combinations of Glucose Tolerance and Blood Pressure Status and Incident Diabetes, Hypertension, and Chronic Kidney Disease

Arash Derakhshan et al. J Am Heart Assoc. .

Abstract

Background: The impact of different combinations of glucose tolerance and blood pressure status on the development of type 2 diabetes mellitus (T2DM), hypertension (HTN), and chronic kidney disease (CKD) still needs to be investigated.

Methods and results: A total of 12 808 Iranian adults aged ≥20 years were included in 3 separate analyses to investigate incidence of T2DM, HTN, and CKD. Multivariate Cox proportional hazard models were used to calculate hazard ratios (95% CI). During a median follow-up of >10 years, the overall incidence rate for T2DM, HTN, and CKD was 12.2, 29.8, and 24.8 per 1000 person-years. For incident T2DM, considering normal glucose tolerance/normal blood pressure as reference, prediabetes (PreDM)/HTN had the highest risk (hazard ratio: 7.22 [5.71-9.12]) while PreDM/normal blood pressure also showed a significant risk (5.58 [4.41-7.05]). Furthermore, risk of PreDM/HTN was higher than PreDM/normal blood pressure (P<0.05). For incident HTN, normal glucose tolerance/prehypertension was a strong predictor (3.28 [2.91-3.69]); however, addition of PreDM or T2DM did not increase the risk. For incident CKD, every category that included HTN and/or T2DM showed significant risk; this risk was marginally significant for the PreDM/HTN group (1.19 [0.98-1.43], P=0.06). In addition, PreDM/ normal blood pressure was a marginally significant risk factor for incident HTN while normal glucose tolerance/prehypertension was a significant predictor of T2DM.

Conclusions: Presence of HTN was associated with increased risk of T2DM among the PreDM population; however, dysglycemia did not increase the risk of HTN among individuals with prehypertension. For incident CKD, intensive management of HTN and T2DM, rather than their predisease states, should be considered.

Keywords: blood pressure; chronic kidney disease; diabetes; glucose tolerance; hypertension; prediabetes; prehypertension.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of the study population, Tehran Lipid and Glucose Study, 1999–2015.
See this image and copyright information in PMC

References

    1. Wang W, Lee ET, Fabsitz RR, Devereux R, Best L, Welty TK, Howard BV. A longitudinal study of hypertension risk factors and their relation to cardiovascular disease: the Strong Heart Study. Hypertension. 2006;47:403–409. - PubMed
    1. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang Y‐H, Stevens GA. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country‐years and 2.7 million participants. Lancet. 2011;378:31–40. - PubMed
    1. Stahl CH, Novak M, Lappas G, Wilhelmsen L, Björck L, Hansson P‐O, Rosengren A. High‐normal blood pressure and long‐term risk of type 2 diabetes: 35‐year prospective population based cohort study of men. BMC Cardiovasc Disord. 2012;12:89. - PMC - PubMed
    1. Ferrannini E, Cushman WC. Diabetes and hypertension: the bad companions. Lancet. 2012;380:601–610. - PubMed
    1. Group TS . Rapid rise in hypertension and nephropathy in youth with type 2 diabetes: the TODAY clinical trial. Diabetes Care. 2013;36:1735–1741. - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources