Hypertension and Diabetes Mellitus Coprediction and Time Trajectories

被引:173
作者
Tsimihodimos, Vasilis [1 ]
Gonzalez-Villalpando, Clicerio [2 ]
Meigs, James B. [3 ,4 ]
Ferrannini, Ele [5 ]
机构
[1] Univ Pisa, Dept Clin & Expt Med, Via Roma 67, I-56100 Pisa, Italy
[2] Inst Nacl Salud Publ, Ctr Invest Salud Poblac, Unidad Invest Diabet & Riesgo Cardiovasc, Ctr Estudios Diabet, Mexico City, DF, Mexico
[3] Massachusetts Gen Hosp, Div Gen Internal Med Div, Boston, MA 02114 USA
[4] Harvard Med Sch, Dept Med, Boston, MA USA
[5] CNR, Inst Clin Physiol, Pisa, Italy
基金
美国国家卫生研究院;
关键词
blood pressure; diabetes mellitus; heart rate; hypertension; insulin resistance; BLOOD-PRESSURE; CARDIOVASCULAR OUTCOMES; BODY-MASS; INSULIN; LEPTIN; EMPAGLIFLOZIN; LIRAGLUTIDE; DYSFUNCTION; DISEASE; ADULTS;
D O I
10.1161/HYPERTENSIONAHA.117.10546
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Type 2 diabetes mellitus and hypertension overlap in the population. In many subjects, development of diabetes mellitus is characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs during the development of hypertension is not known. We analyzed the pattern of blood pressure (BP) changes during the development of hypertension in patients with or without diabetes mellitus using data from the MCDS (Mexico City Diabetes Study; a population-based study of diabetes mellitus in Hispanic whites) and in the FOS (Framingham Offspring Study, a community-based study in non-Hispanic whites) during a 7-year follow-up. Diabetes mellitus at baseline was a significant predictor of incident hypertension (in FOS, odds ratio, 3.14; 95% confidence interval, 2.17-4.54) independently of sex, age, body mass index, and familial diabetes mellitus. Conversely, hypertension at baseline was an independent predictor of incident diabetes mellitus (in FOS, odds ratio, 3.33; 95% CI, 2.50-4.44). In >60% of the converters, progression from normotension to hypertension was characterized by a steep increase in BP values, averaging 20 mm Hg for systolic BP within 3.5 years (in MCDS). In comparison with the nonconverters group, hypertension and diabetes mellitus converters shared a metabolic syndrome phenotype (hyperinsulinemia, higher body mass index, waist girth, BP, heart rate and pulse pressure, and dyslipidemia). Overall, results were similar in the 2 ethnic groups. We conclude that (1) development of hypertension and diabetes mellitus track each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BP values, and (3) insulin resistance is one common feature of both prediabetes and prehypertension and an antecedent of progression to 2 respective disease states.
引用
收藏
页码:422 / 428
页数:7
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