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November 18, 2025Korean Journal of Family MedicineOpen Access

SBP changes ≥10 mm Hg linked to ~6% higher risk of new-onset diabetes.

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Why the study?

With the increasing global prevalence of diabetes mellitus, identifying risk factors is important, prompting investigation into the association between systolic blood pressure changes and incident diabetes.

Is a change in systolic blood pressure associated with the incidence of diabetes mellitus in a general screening population?

Population

152,547 participants in the Korean National Health Insurance Service Health Screening Database

Comparison

SBP decrease (≥10 mm Hg) vs no change (<10 mm Hg) vs increase (≥10 mm Hg)

Design

Retrospective cohort study

Follow-up

Median 14.3 years

Key result

Changes in systolic blood pressure of ≥10 mm Hg, whether a decrease (HR 1.06 in males) or an increase (HR 1.10 in males), were associated with a higher risk of new-onset diabetes mellitus compared to no change.

Authors

HYHyo‐Sun YouJKJeong Sook KimJKJoungyoun Kim

Discussion

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Member takes

Overview

No immediate practice change from SBP fluctuations alone; leaves open causality in this observational cohort.

Study Design

Type

Cohort (n=152,547)

Multicenter

Yes

Structured PICO

Is a change in systolic blood pressure associated with the incidence of diabetes mellitus in a general screening population?

P
Population
152,547 participants from the Korean National Health Insurance Service Health Screening Database who underwent two consecutive health checkups between 2002 and 2003, and 2004 and 2005
I
Intervention
Change in systolic blood pressure (SBP): decrease (≥10 mm Hg) or increase (≥10 mm Hg)
C
Comparator
No change in SBP (<10 mm Hg)
O
Outcome
Incidence of diabetes mellitushard clinical

Main Result

Effect estimate: HR 1.06 (95% CI 1.02-1.10)

Both decreases and increases in systolic blood pressure of ≥10 mm Hg are associated with a slightly increased risk of incident diabetes mellitus compared to stable blood pressure.

Limitations

  • The reason for the observed decrease in SBP compared with baseline remains unclear, making it difficult to determine causality.
  • Detailed information on lifestyle-related risk factors, such as sedentary time, was not available.
  • The interval between initial and subsequent BP measurements was limited to a maximum of 3 years.
  • General conditions on the day of health screening, such as dehydration or psychological tension, could not be evaluated.
  • White-coat or masked hypertension could not be controlled.
  • Residual confounding factors due to unmeasured, time-varying factors over the long follow-up period.

Cite This Study

You et al. (2025) conducted a cohort in Diabetes mellitus (n=152,547). Change in systolic blood pressure (≥10 mm Hg decrease or increase) vs. No change in systolic blood pressure (<10 mm Hg) was evaluated on Incidence of diabetes mellitus (HR 1.06, 95% CI 1.02-1.10). Changes in systolic blood pressure of ≥10 mm Hg, whether a decrease (HR 1.06 in males) or an increase (HR 1.10 in males), were associated with a higher risk of new-onset diabetes mellitus compared to no change.

synapsesocial.com/papers/6a0841b2ef79633196e8ac46https://doi.org/10.4082/kjfm.25.0101
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