Key result
In non-diabetic Chinese adults, elevated HbA1c levels in the highest quartile were associated with a significantly increased risk of hypertension compared to the lowest quartile (OR 1.90).
Why the study?
Abnormal glucose metabolism may contribute to hypertension, but the associations and interactions of HbA1c with other factors on hypertension risk in non-diabetic adults remained unclear.
Does elevated HbA1c increase the risk of hypertension in non-diabetic adults?
Cross-Sectional (n=1,462)
No
Does elevated HbA1c increase the risk of hypertension in non-diabetic adults?
Odds Ratio: 1.9 (95% CI 1.28–2.8)
Absolute Event Rate: 30.7% vs 14.7%
p-value: p=<0.001
Elevated HbA1c is independently and synergistically associated with an increased risk of hypertension in non-diabetic Chinese adults, particularly when combined with abdominal obesity or a family history of hypertension.
HbA1c may aid hypertension risk stratification in non-diabetics; cross-sectional data leave open causality and prospective validation.
Background Abnormal glucose metabolism have been suggested to be involved in the development of hypertension. The present study aimed to investigate the associations and potential interactions of hemoglobin A1c (HbA1c) with other factors on the risk of hypertension among Chinese non-diabetic adults. Methods As a cross-sectional survey, the current work provided questionnaire survey, anthropometric tests and biochemical measure for each of the eligible participants. The HbA1c levels were quantified and grouped by quartiles. The correlation between HbA1c and hypertension risk in non-diabetic was investigated by univariate and multivariate analyses. For evaluating the interactive effects, the parameters of Relative Excess Risk due to Interaction (RERI), Attributable Proportion due to Interaction (AP) and Synergy Index (SI) were calculated, respectively. Results In the current study, 1462 non-diabetic subjects were enrolled. Totally, the prevalence of hypertension was 22.4% (n=327) in the individuals without diabetes. When the HbA1c levels were grouped by quartiles, it was revealed that the prevalence of hypertension substantially elevated across groups ( P for trend <0.001). In the multivariable logistic regression analyses, in comparison with the first quartile of HbA1c, the normalized OR for hypertension risk were 1.90 (95% CI:1.28-2.80) for the highest quartile. Also, the risk of ISH also significantly increased with HbA1c levels in the highest quartile as compared with the bottom quartile(OR: 2.23,95% CI:1.47-3.71). Besides, the ROC curve analysis indicated that the best threshold of HbA1c as the predictor for hypertension risk was 4.95 in non-diabetic subjects, with the AUC of 0.60 (0.58-0.63). Eventually, it was demonstrated from the interactive effect analysis that the HbA1c significantly interacted with abdominal obesity (RERI: 1.48, 95% CI: 0.38-2.58; AP: 0.37, 95% CI: 0.14-0.60 and SI: 1.96, 95% CI: 1.06-3.62) and family history of hypertension (AP: 0.37, 95% CI: 0.05-0.70) on the risk of hypertension in non-diabetic participants. Conclusion The risk of hypertension was aggravated by the up-regulated HbA1c in an independent and synergistic manner with abdominal obesity and family history of hypertension in Chinese subjects without diabetes.
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Song et al. (2020) conducted a cross-sectional in Hypertension (n=1,462). Elevated HbA1c levels vs. Lowest quartile of HbA1c was evaluated on Risk of hypertension (OR 1.90, 95% CI 1.28-2.80, p=<0.001). In non-diabetic Chinese adults, elevated HbA1c levels in the highest quartile were associated with a significantly increased risk of hypertension compared to the lowest quartile (OR 1.90).
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