Different cutoffs of hypertension, risk of incident diabetes and progression of insulin resistance: A prospective cohort study

Chia Hung Lin, Jung Nan Wei, Kang Chih Fan, Chi Tai Fang, Wan Chen Wu, Chung Yi Yang, Mao Shin Lin, Shyang Rong Shih, Cyue Huei Hua, Yenh Chen Hsein, Jou Wei Lin, Lee Ming Chuang, Hung Yuan Li*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

15 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)193-201
Number of pages9
JournalJournal of the Formosan Medical Association
Volume121
Issue number1
DOIs
StatePublished - 01 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 Formosan Medical Association

Keywords

  • Cutoffs
  • Diabetes mellitus
  • Hypertension
  • Insulin resistance

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