OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Blood Pressure ; Body Mass Index ; Classification ; Cohort Studies* ; Diabetes Mellitus* ; Education ; Hypertension ; Incidence* ; Iran ; Joints ; Models, Structural* ; Odds Ratio ; Prehypertension* ; Prospective Studies* ; Risk Assessment ; Smoke ; Smoking

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Blood Pressure ; Body Mass Index ; Classification ; Cohort Studies ; Diabetes Mellitus ; Education ; Hypertension ; Incidence ; Iran ; Joints ; Models, Structural ; Odds Ratio ; Prehypertension ; Prospective Studies ; Risk Assessment ; Smoke ; Smoking

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.

OBJECTIVES: Considering the increase in the non-communicable diseases associated with tobacco use in recent decades in Iran, it is necessary to have a general view of the current condition. This study aimed to identify factors associated with tobacco use and to estimate the probability of a 5-year transition in the stages of tobacco use in an adult population. METHODS: In this study, 5190 people in the 40-64-year-old population of Shahroud (North East of Iran) were interviewed in 2009 and 2014 on tobacco smoking. The association of independent variables with tobacco smoking was evaluated using the population-averaged logit model. We calculated smoking transition probabilities from non-smoking to current smoking and past-smoking stages during a 5-year span. RESULTS: The prevalence of current tobacco smoking in 40-69-years age group was 11.1% (95% CI 10.3-12.0), 1% among women (95% CI 0.8-1.3) and 25.6% among men (95% CI 23.7-27.6). During this 5-year period, the probability of transition of a non-smoker to an overall current tobacco smoker was 2.3%. Meanwhile, 18.5% of the overall current tobacco smokers had changed into past smokers. Unemployed (OR = 2), male gender (OR = 53.9), widow/widowers (OR = 5.4), divorces (OR = 3.3), and high economic status (OR = 1.2) are associated to tobacco smoking. CONCLUSIONS Compared with the other studies, the prevalence of tobacco use in this population is low but transition rate of non-smokers into current smokers or past smokers is high. Conducting interventions on determinants of starting and quitting smoking and education and awareness raising on the risk and harms of smoking seems necessary.
Adult ; Age Factors ; Aged ; Female ; Humans ; Iran ; epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sex Factors ; Socioeconomic Factors ; Time Factors ; Tobacco Use ; epidemiology