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
. 2017 May 2;17(1):106.
doi: 10.1186/s12872-017-0537-y.

Time-cumulated blood pressure exposure and incident impairment of glucose tolerance and diabetes mellitus

Yun Tao Wu  1   2 , Lu Song  2   3 , Xiao Xue Liu  4 , Jing Sheng Gao  2 , Xiao Ming Zheng  2 , Chun Yu Ruan  2 , Hai Yan Zhao  2 , Shuo Hua Chen  5 , Wen Yuan Gao  6 , Jost B Jonas  7 , Shou Ling Wu  8
Affiliations

Time-cumulated blood pressure exposure and incident impairment of glucose tolerance and diabetes mellitus

Yun Tao Wu et al. BMC Cardiovasc Disord. .

Abstract

Background: With the marked increase in the prevalence of diabetes mellitus, it was the purpose of our study to assess a potential association of time-cumulated exposure to systolic (CumSBP) and of diastolic blood pressure (CumDBP) with onset of impaired glucose tolerance and diabetes mellitus.

Methods: The prospective investigation included participants of the longitudinal Kailuan Study with three baseline examinations in 2006-2007, 2008-2009 and 2010-2011, re-examination in 2012-2013, and no diabetes mellitus at baseline. Cumulative blood pressure (BP) was calculated as cumBP = [(BP1 + BP2)/2 × time1-2] + [(BP2 + BP3)/2 × time2-3]. Based on cumSBP, the study population was stratified into four groups (cumSBP < 480mmHgxyear;n = 15,339; 480mmHgxyear ≤ cumSBP < 520mmHgxyear;n = 7214; 520mmHgxyears ≤ cumSBP < 560mmHgxyears;n = 5675; and cumSBP ≥ 560mmHgxyears;n = 10,576).

Results: After adjusting for demographic, anthropomorphic, biochemical, socioeconomic and lifestyle parameters and as compared with the first group, the second, third and fourth group showed a significantly higher incidence of diabetes (P-trend < 0.001;hazard ratio (HR);95% confidence interval (CI):1.28(1.08,1.51),1.54(1.29,1.84), and 2.33(1.98,2.73), respectively), higher incidence of impairment of glucose tolerance (P-trend < 0.001;HR;95% CI1.17(1.02,1.33), 1.43(1.25,1.64), and 2.09(1.85,2.37), respectively), and higher incidence of diabetes developing out of an impairment of glucose tolerance (P-trend < 0.001;HR;95% CI:1.22(0.97,1.54),1.47(1.16,1.86), and 2.01(1.62,2.50), respectively). An increase in cumSBP by 10 mmHg/year or an increase in cumDBP by 5 mmHg/year was associated with a hazard ratio of incident diabetes of 1.04 (95% CI:1.03,1.04) and 1.02(1.02,1.03), respectively, with a hazard ratio of incident impairment of glucose tolerance of 1.04(95% CI:1.03,1.04) and 1.03(95% CI:1.02,1.03), respectively, and with a hazard ratio of incident diabetes developing from impairment of glucose tolerance of 1.04(95% CI:1.03,1.04) and 1.03(95% CI:1.02,1.03), respectively.

Conclusions: Time-cumulated exposure to elevated blood pressure was significantly associated with an elevated incidence of impaired glucose tolerance and diabetes.

Keywords: Cumulative blood pressure exposure; Incident diabetes; Incident glucose tolerance impairment; Kailuan study.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Scheme showing the inclusion and exclusion of study participants
Fig. 2
Fig. 2
a Development of Impairment of Glucose Tolerance in 2563 (8.0%) Individuals out of 31,935 Participants Without Impairment of Glucose Tolerance and Without Diabetes at the Baseline Examinations. b Development of New-Onset of Diabetes in 874 (12.7%) Individuals out of 6869 Participants with Impaired Glucose Tolerance at the Baseline Examinations
See this image and copyright information in PMC

References

    1. Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459–1544. doi: 10.1016/S0140-6736(16)31012-1. - DOI - PMC - PubMed
    1. Kassebaum NJ, Arora M, Barber RM, Bhutta ZA, Brown J, Carter A, et al. Global, regional, and national disability-adjusted life years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2015: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 Study. Lancet. 2016;388:1603–1658. doi: 10.1016/S0140-6736(16)31460-X. - DOI - PMC - PubMed
    1. Kannel WB, McGee DL. Diabetes and cardiovascular risk factors: the Framingham study. Circulation. 1979;59:8–13. doi: 10.1161/01.CIR.59.1.8. - DOI - PubMed
    1. Forouzanfar MH, Afshin A, Alexander LT, Anderson HR, Bhutta ZA, Biryukov S, et al. Global, regional and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 195 countries: 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1659–724. - PMC - PubMed
    1. Hayashi T, Tsumura K, Suematsu C, Endo G, Fujii S, Okada K. High normal blood pressure, hypertension, and the risk of type 2 diabetes in Japanese men. The Osaka Health Survey. Diabetes Care. 1999;22:1683–1687. doi: 10.2337/diacare.22.10.1683. - DOI - PubMed

MeSH terms