Key result
Treated hypertension is linked to ~198% higher incident diabetes risk versus normal blood pressure.
Why the study?
Hypertension is a risk factor for incident diabetes, but the impact of updated ACC/AHA diagnostic cutoffs (above 130/80 mmHg) versus traditional ESC/ESH and JNC7 cutoffs (140/90 mmHg) on incident diabetes and insulin resistance progression was unknown.
Does hypertension defined by different cutoffs affect the risk of incident diabetes and progression of insulin resistance in subjects without diabetes?
Cohort (n=1,177)
Does hypertension defined by different cutoffs affect the risk of incident diabetes and progression of insulin resistance in subjects without diabetes?
Answers are grounded in this paper and cite their sources.
Hypertension is associated with incident diabetes and accelerated progression of insulin resistance, but the strength of this association is attenuated when using the lower 2017 ACC/AHA blood pressure cutoffs.
BACKGROUND/PURPOSE: Hypertension is a risk factor of incident diabetes. In 2017, the ACC/AHA updated the definition of hypertension to above 130/80 mmHg, while the 2018 ESC/ESH guideline and the JNC7 criteria remained the cutoff of 140/90 mmHg. This study was aimed to investigate how different cutoffs of hypertension affect the association of hypertension to incident diabetes and the progression of insulin resistance. METHODS: A total of 1177 subjects without diabetes at baseline were followed for 4.5 years. Diabetes was diagnosed by the results of oral glucose tolerance tests and hemoglobin A1c, or if anti-diabetic agents were used. RESULTS: Hypertension by both criteria was associated with incident diabetes. Change of HOMA2-IR every 5 years (ΔHOMA2-IR/5 yr) was higher in subjects with hypertension than those without (adjusted p = 0.044). Subjects with treated hypertension had the highest risk of diabetes (HR 2.98, p < 0.001) and ΔHOMA2-IR/5 yr, compared with subjects with normal blood pressure. However, the associations of hypertension, HR of incident diabetes and ΔHOMA2-IR/5 yr were attenuated by the 2017 ACC/AHA criteria, as compared with that by the JNC7 and 2018 ESC/ESH criteria. CONCLUSION: Hypertension by both criteria is associated with incident diabetes and accelerated progression of insulin resistance, and the associations are attenuated by the 2017 ACC/AHA criteria.
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Lin et al. (2021) conducted a cohort in Hypertension (n=1,177). Hypertension (different cutoffs) vs. Normal blood pressure was evaluated on Incident diabetes (HR 2.98, p=<0.001). Treated hypertension was associated with a higher risk of incident diabetes compared to normal blood pressure (HR 2.98, p<0.001), though associations were attenuated by the 2017 ACC/AHA criteria.
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