Objective: No prospective, community-based cohort studies have investigated the association between blood pressure and diabetes in Asian ethnicity. We investigated this issue in a 10-year prospective, community-based study of Koreans.
Research design and methods: We studied whether high blood pressure was associated with the development of diabetes in a population-based cohort, where we sampled ∼5,000 random subjects each from rural and urban areas (age range 40-69 years) during 2001-2010. Among 10,038 subjects, 8,359 without diabetes at baseline were categorized into normal (n = 4,809), prehypertension (n = 2,141), stage 1 hypertension (n = 804), and stage 2 hypertension (n = 605) groups, according to their blood pressure readings of <120/80 mmHg, 120-139/80-89 mmHg, 140-159/90-99 mmHg, and ≥160/100 mmHg, respectively. The development of diabetes was defined as a fasting glucose concentration of ≥126 mg/dL or a postload glucose concentration of ≥200 mg/dL, based on a 75-g oral glucose tolerance test, or the use of antidiabetic medication.
Results: During the 10-year follow-up period, diabetes developed in 1,195 subjects (14.3%). The incidence of diabetes increased from 11.1% in the normal group to 17.0% in the prehypertension group, 17.7% in the stage 1 hypertension group, and 25.8% in the stage 2 hypertension group (P < 0.001). After adjusting for anthropometric factors; family history of diabetes; biochemical parameters including C-reactive protein, A1C, and fasting glucose and postload 2-h glucose levels; and the use of lipid-lowering medications, the hazard risks of diabetes development were 1.23 (95% CI 1.06-1.42), 1.26 (1.04-1.54), and 1.60 (1.30-1.96), respectively, in the prehypertension, stage 1 hypertension, and stage 2 hypertension groups.
Conclusions: Our findings indicate a grade association of baseline blood pressure with the development of diabetes in Korean individuals.
© 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.