Tai T Y, Chuang L M, Chen C J, Lin B J
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei.
Diabetes Care. 1991 Nov;14(11):1013-20. doi: 10.2337/diacare.14.11.1013.
To elucidate the relationship between hypertension and non-insulin-dependent diabetes.
The study consisted of a random sample of adults aged greater than or equal to 40 yr from the Ta-An district of Taipei City and 5 of 12 villages of Taiwan province, which had established primary health-care centers since 1984. A total of 11,478 subjects were recruited into the survey with a response rate of 65.3 and 72%, respectively. Blood glucose and blood pressure levels were measured, and a structured questionnaire was given to each participant. Those identified as having diabetes received further blood tests for lipids and creatinine and were evaluated for vascular complications.
The age- and sex-adjusted prevalence of hypertension among diabetic subjects was twice that of nondiabetic subjects (30.6 vs. 16.4%, P less than 0.0005). Hypertensive subjects had a higher prevalence of diabetes than normotensive subjects (10.2 vs. 4.9%, P less than 0.0005). Among hypertensive subjects, the prevalence of diabetes was 12.7% for those taking antihypertensive drugs and 9.1% for those not taking any drug (P less than 0.05). The prevalence of diabetes significantly increased as mean arterial pressure rose, whether the subjects were stratified by various factors. Multiple regression analysis, including sex, age, body mass index, and other risk factors as independent variables, also showed a significant association between diabetes and hypertension.
The univariate and multivariate analyses revealed that there seemed to be a tight link between hypertension and non-insulin-dependent diabetes. Family history of diabetes, diabetes duration, diabetes regimen, control of blood glucose, and the presence of nephropathy, as attested by proteinuria, did not contribute to the risk of hypertension. Further studies are necessary to determine whether these two conditions are causally related.
阐明高血压与非胰岛素依赖型糖尿病之间的关系。
本研究包括来自台北市大安地区及台湾省12个村庄中5个村庄的40岁及以上成年人的随机样本，这些村庄自1984年起设立了初级保健中心。共有11478名受试者被纳入调查，应答率分别为65.3%和72%。测量血糖和血压水平，并向每位参与者发放一份结构化问卷。被确定患有糖尿病的患者接受进一步的血脂和肌酐血液检测，并评估血管并发症。
糖尿病患者中经年龄和性别调整后的高血压患病率是非糖尿病患者的两倍（30.6%对16.4%，P<0.0005）。高血压患者的糖尿病患病率高于血压正常者（10.2%对4.9%，P<0.0005）。在高血压患者中，服用抗高血压药物者的糖尿病患病率为12.7%，未服用任何药物者为9.1%（P<0.05）。无论受试者按各种因素分层，糖尿病患病率均随平均动脉压升高而显著增加。包括性别、年龄、体重指数和其他危险因素作为自变量的多元回归分析也显示糖尿病与高血压之间存在显著关联。
单变量和多变量分析显示，高血压与非胰岛素依赖型糖尿病之间似乎存在紧密联系。糖尿病家族史、糖尿病病程、糖尿病治疗方案、血糖控制以及蛋白尿证实的肾病存在均与高血压风险无关。需要进一步研究以确定这两种情况是否存在因果关系。
