Key result
Higher systolic blood pressure linked to ~9% higher diabetes risk per 10-mmHg increase.
Why the study?
The comparative strengths of association and predictive performance of various blood pressure parameters for incident diabetes among adults with elevated blood pressure were unclear.
Do different blood pressure parameters predict incident diabetes in Chinese adults with elevated blood pressure?
Cohort (n=29,377)
Yes
Do different blood pressure parameters predict incident diabetes in Chinese adults with elevated blood pressure?
Hazard Ratio: 1.09 (95% CI 1.05–1.13)
p-value: p=<0.001
In adults with elevated blood pressure, systolic blood pressure demonstrates the highest predictive value for incident diabetes and shows significant non-linear associations, indicating that BP parameters can provide supplementary information for diabetes risk stratification.
May inform diabetes risk assessment among Chinese adults with elevated BP; leaves open whether SBP reduction prevents diabetes.
Aims: This study aimed to compare the strengths of association and predictive performance of systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), pulse pressure (PP), pulse pressure index (PPI), and the SBP/DBP ratio for incident diabetes among Chinese adults with elevated BP. Methods: This retrospective cohort study included 29,377 adults with elevated BP from a large Chinese health examination database. Cox proportional hazards models were used to estimate hazard ratios (HRs), and restricted cubic spline analyses were applied to evaluate non-linear associations. Results: During a median follow-up of 2.98 years, 1,550 participants (5.28%) developed diabetes. After multivariable adjustment, SBP (HR: 1.09, 95% CI 1.05-1.13), MAP (HR 1.07, 95% CI 1.02-1.13), PP (HR 1.06, 95% CI 1.03-1.10), PPI (HR 2.47, 95% CI 1.36-4.46), and the SBP/DBP ratio (HR 1.38, 95% CI 1.13-1.70) were significantly associated with incident diabetes. Restricted cubic spline analyses revealed significant non-linear relationships for SBP, DBP, MAP, and the SBP/DBP ratio. Among all BP parameters, SBP demonstrated the highest predictive performance. Conclusions: Among Chinese adults with elevated BP, several BP parameters were associated with incident diabetes, and significant non-linear dose-response relationships were observed for SBP, DBP, MAP, and the SBP/DBP ratio. SBP showed the highest predictive performance, suggesting that BP parameters may provide simple supplementary information for diabetes risk stratification in this high-risk population.
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Wu et al. (2026) conducted a cohort in Elevated blood pressure (n=29,377). Systolic blood pressure (SBP) vs. Lower systolic blood pressure was evaluated on Incident diabetes (HR 1.09, 95% CI 1.05-1.13, p=<0.001). In Chinese adults with elevated blood pressure, each 10-mmHg increase in systolic blood pressure was independently associated with a 9% higher risk of incident diabetes (HR 1.09).
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