Key result
Individuals in the stage II hypertension-increasing systolic blood pressure trajectory had a 3.91-fold higher risk of incident diabetes compared to those in the normotensive-stable group.
Why the study?
Do higher life-course systolic blood pressure trajectories increase the risk of incident diabetes in adults?
Cohort (n=4,625)
Do higher life-course systolic blood pressure trajectories increase the risk of incident diabetes in adults?
Long-term systolic blood pressure trajectories, even within the prehypertensive range, are significant independent predictors of incident diabetes in young to middle-aged adults.
BP trajectory monitoring may aid diabetes risk stratification; leaves open whether intervening alters incidence.
Background: Blood pressure levels are correlated with diabetes among middle-aged or older adults. However, longitudinal trajectories of blood pressure during young adulthood and their impact on diabetes have been insufficiently studied. Methods: The longitudinal cohort consisted of 4,625 adults who had blood pressure and body mass index (BMI) repeatedly measured five to nine times during 18-60 years of age. Distinct systolic blood pressure (SBP) trajectories were identified by a group-based trajectory model. Logistic regression analyses were used to investigate the association between trajectory patterns or quartiles of area under the curve values of SBP trajectories and incident diabetes, respectively. Results: Four distinct trajectory groups were identified for SBP: normotensive-stable (n = 761, 16.5%), prehypertension-stable (n = 2,381, 51.5%), stage I hypertension-increasing (n = 1,231, 26.6%), and stage II hypertension-increasing (n = 251, 5.4%). Compared with subjects who remained at SBP <120 mmHg in the normotensive-stable group, individuals in the prehypertension-stable trajectory exhibited a normal SBP range (<140 mmHg), and they still had a significantly higher risk of diabetes (adjusted OR = 1.82, p = 0.029). Individuals had a greater risk of diabetes in the stage I hypertension-increasing group (adjusted OR = 2.31, p = 0.006) and the highest risk in the stage II hypertension-increasing group (adjusted OR = 3.91, p < 0.001) relative to the normotensive-stable group. Furthermore, compared with the first quartile, adjusted ORs (95% CIs) of the fourth quartile of SBP incremental and total AUC were 2.50 (1.61-3.97) and 1.82 (1.15-2.94), respectively. Conclusions: Long-term SBP trajectory is a significant predictor for incident diabetes, which is independent of baseline SBP and body weight, attaching importance to maintaining optimal blood pressure levels and controlling changing slopes of SBP for preventing diabetes.
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Liu et al. (2022) conducted a cohort in Incident diabetes (n=4,625). Stage II hypertension-increasing systolic blood pressure trajectory vs. Normotensive-stable systolic blood pressure trajectory was evaluated on Incident diabetes (OR 3.91, 95% CI 1.93-8.13, p=<0.001). Individuals in the stage II hypertension-increasing systolic blood pressure trajectory had a 3.91-fold higher risk of incident diabetes compared to those in the normotensive-stable group.
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