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Cardiovascular and metabolic risk
Risk of hypertension in middle-aged and elderly participants with newly diagnosed type 2 diabetes and prediabetes
  1. Nobuo Sasaki1,
  2. Ryoji Ozono2,
  3. Ryo Maeda1,
  4. Yukihito Higashi3
  1. 1Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan
  2. 2Department of General Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
  3. 3Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
  1. Correspondence to Dr Nobuo Sasaki; nb7ssk7{at}sd6.so-net.ne.jp

Abstract

Introduction Little is known about the risk of hypertension in patients with the early stage of type 2 diabetes. We investigated the risk of hypertension in participants with newly diagnosed type 2 diabetes and prediabetes.

Research design and methods This is a retrospective cohort study consisting of 2136 middle-aged participants (1022 with normal fasting glucose/normal glucose tolerance (NFG/NGT), 418 with impaired fasting glucose (IFG), 466 with impaired glucose tolerance (IGT) and 230 with diabetes) and 3426 elderly participants (1762 with NFG/NGT, 599 with IFG, 781 with IGT, and 284 with diabetes). All participants underwent 75 g oral glucose tolerance tests at baseline.

Results Over a median 59-month follow-up period, 459 middle-aged and 1170 elderly participants developed hypertension. In middle-aged participants, the odds of incident hypertension were significantly higher in those with IFG (OR 1.40; p=0.019), IGT (OR 1.49; p=0.004), and diabetes (OR 1.55; p=0.013) than those with NFG/NGT, which was no longer significant after adjustment for body mass index. Subgroup analysis showed that the risk of hypertension was significantly higher in diabetes than NFG/NGT only in participants without obesity. Conversely, obesity was a risk factor of hypertension only in those with IFG and NFG/NGT. In elderly participants, there was no difference in the risk of hypertension among the NFG/NGT, IFG, IGT and diabetes groups.

Conclusions The risk of hypertension is modest in participants with newly diagnosed type 2 diabetes and prediabetes. Our findings suggest that the early stages of type 2 diabetes and prediabetes may be a key period for reducing hypertension, given the pronounced risk of hypertension in patients with diabetes reported in previous studies. In terms of reducing the risk for hypertension, obesity treatment might be advantageous in the early stages rather than the advanced stages of impaired glucose metabolism.

  • diabetes mellitus
  • type 2
  • hypertension
  • obesity
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2020-001500

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    Footnotes

    • Contributors NS conducted the analysis, interpreted data and wrote the manuscript. RO contributed to interpretation of data. RM contributed to data acquisition and interpretation of data. YH contributed to study design and interpretation of data. All authors critically reviewed and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was performed in line with the principles of the Declaration of Helsinki. Ethical approval for this study was obtained from the Hiroshima Atomic Bomb Casualty Council Committee on the Ethics of Human Research (approval number 00032).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request. The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.