期刊
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
卷 121, 期 1, 页码 193-201出版社
ELSEVIER TAIWAN
DOI: 10.1016/j.jfma.2021.02.022
关键词
Cutoffs; Diabetes mellitus; Hypertension; Insulin resistance
资金
- Ministry of Science and Technology, Taiwan [MOST 104-2314-B-002-124-MY3, MOST 106-2314-B-041-001]
Hypertension defined by both criteria is associated with incident diabetes and accelerated progression of insulin resistance, with the associations attenuated by the 2017 ACC/AHA criteria.
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 (DHOMA2-IR/5 yr) was higher in subjects with hypertension than those without (adjusted p Z 0.044). Subjects with treated hypertension had the highest risk of diabetes (HR 2.98, p < 0.001) and DHOMA2-IR/5 yr, compared with subjects with normal blood pressure. However, the associations of hypertension, HR of incident diabetes and DHOMA2-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. Copyright 2021, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
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