Journal
CARDIOVASCULAR DIABETOLOGY
Volume 20, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12933-021-01434-z
Keywords
Hypertension; Type 2 diabetes mellitus; UK biobank; Lifestyle pattern
Funding
- National Key R&D Program of China [2020YFA0803800, 2020YFC2003401]
- Peking University [BMU2018YJ002]
- High-performance Computing Platform of Peking University
- China-Canada Key Lab of Nutrition and Health at Beijing Technology and Business University [88442Y0033]
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Adherence to a healthy lifestyle pattern, including a healthy sleep pattern, is associated with a lower risk of developing T2DM in hypertensives, with even greater benefits observed in normotensives.
Background Evidence is limited regarding the association of healthy lifestyle including sleep pattern with the risk of complicated type 2 diabetes mellitus (T2DM) among patients with hypertension. We aimed to investigate the associations of an overall healthy lifestyle including a healthy sleep pattern with subsequent development of T2DM among participants with hypertension compared to normotension, and to estimate how much of that risk could be prevented. Methods This study examined six lifestyle factors with T2DM cases among hypertension (227,966) and normotension (203,005) and their interaction in the UK Biobank. Low-risk lifestyle factors were defined as standard body mass index (BMI), drinking alcohol in moderation, nonsmoking, engaging in moderate- to vigorous-intensity physical activity, eating a high-quality diet, and maintaining a healthy sleep pattern. Results There were 12,403 incident T2DM cases during an average of 8.63 years of follow-up. Compared to those with 0 low-risk lifestyle factors, HRs for those with 5-6 were 0.14 (95% CI 0.10 to 0.19) for hypertensive participants, 0.13 (95% CI 0.08 to 0.19) for normotensive participants, respectively (p(trend) < 0.001). 76.93% of hypertensive participants were considerably less likely to develop T2DM if they adhered to five healthy lifestyle practices, increased to 81.14% if they followed 6-factors (with a healthy sleep pattern). Compared with hypertension adults, normotensive people gain more benefits if they stick to six healthy lifestyles [Population attributable risk (PAR%) 83.66%, 95% CI 79.45 to 87.00%, p for interaction = 0.0011]. Conclusions Adherence to a healthy lifestyle pattern including a healthy sleep pattern is associated with lower risk of T2DM in hypertensives, and this benefit is even further in normotensives.
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