Kim Min-Ju, Lim Nam-Kyoo, Choi Sun-Ja, Park Hyun-Young
Division of Cardiovascular and Rare Diseases, Center for Biomedical Science, Korea National Institute of Health, Chungbuk, Korea.
Hypertens Res. 2015 Nov;38(11):783-9. doi: 10.1038/hr.2015.72. Epub 2015 Jul 16.
Hypertension and diabetes share common risk factors and frequently co-occur. Although high blood pressure (BP) was reported as a significant predictor of type 2 diabetes, little is known about this association in Korea. This study investigated the relationship of prehypertension and hypertension with type 2 diabetes in 7150 middle-aged Koreans, as well as the effect of BP control on diabetes development over 8 years. At 8 years, 1049 (14.7%) of the 7150 participants had newly developed diabetes, including 11.2, 16.7 and 21.5% of baseline normotensive, prehypertensive and hypertensive subjects, respectively. The overall incidence rate of diabetes was 22.3 events per 1000 person-years. Subjects with baseline prehypertension (hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.09-1.48) and hypertension (HR 1.51; 95% CI, 1.29-1.76) were at higher risk of diabetes than normotensive subjects after controlling for potential confounders (P-value for trend <0.001). These associations persisted even when subjects were stratified by baseline glucose status, sex and body mass index (BMI). The risk of diabetes was significantly higher in subjects who had normal BP at baseline and progressed to prehypertention or hypertension at 8 years (HR, 1.48; 95% CI, 1.20-1.83) than those with controlled BP, but these associations were not observed in subjects with baseline prehypertension and hypertension. These findings showed that prehypertension and hypertension are significantly associated with the development of diabetes, independent of baseline glucose status, sex and BMI. Active BP control reduced incident diabetes only in normotensive individuals, suggesting the need for early BP management.
高血压和糖尿病有共同的风险因素，且经常同时出现。尽管高血压被报道为2型糖尿病的一个重要预测因素，但在韩国关于这种关联的了解甚少。本研究调查了7150名中年韩国人中高血压前期和高血压与2型糖尿病的关系，以及血压控制对8年期间糖尿病发生的影响。8年后，7150名参与者中有1049人（14.7%）新患糖尿病，其中基线血压正常、高血压前期和高血压患者分别为11.2%、16.7%和21.5%。糖尿病的总发病率为每1000人年22.3例。在控制潜在混杂因素后，基线高血压前期（风险比（HR），1.27；95%置信区间（CI），1.09 - 1.48）和高血压（HR 1.51；95% CI，1.29 - 1.76）的受试者患糖尿病的风险高于血压正常的受试者（趋势P值<0.001）。即使按基线血糖状态、性别和体重指数（BMI）对受试者进行分层，这些关联仍然存在。基线血压正常且在8年时进展为高血压前期或高血压的受试者患糖尿病的风险显著高于血压得到控制的受试者（HR，1.48；95% CI，1.20 - 1.83），但在基线高血压前期和高血压的受试者中未观察到这些关联。这些发现表明，高血压前期和高血压与糖尿病的发生显著相关，独立于基线血糖状态、性别和BMI。积极的血压控制仅在血压正常的个体中降低了糖尿病的发病率，这表明需要早期进行血压管理。
