Association between pulse pressure and new-onset diabetes in hypertensive patients.
10.3760/cma.j.cn112148-20200729-00603
- VernacularTitle:高血压人群脉压与新发糖尿病的关系探讨
- Author:
Wei Jian LI
1
;
Wei FANG
1
;
Ze Feng CAI
1
;
Xu HAN
2
;
Meng Yi ZHENG
2
;
Guan Zhi CHEN
3
;
Wei Qiang WU
4
;
Zhi Chao CHEN
4
;
You Ren CHEN
4
;
Shou Ling WU
5
Author Information
1. Department of Clinical Medicine, Shantou University Medical College, Shantou 515000, China Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou 515000, China.
2. Graduate School, North China University of Science and Technology, Tangshan 063000, China.
3. Department of Clinical Medicine, China Medical University, Shenyang 110122, China.
4. Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou 515000, China.
5. Department of Cardiology, Kailuan General Hospital, Tangshan 063000, China.
- Publication Type:Journal Article
- From:
Chinese Journal of Cardiology
2021;49(7):673-679
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To determine the association between pulse pressure and the risk of new-onset diabetes in hypertensive patients. Methods: In this prospective cohort study, hypertensive patients from the Kailuan Study, who were diagnosed in 2006-2007 check-up, were screened for enrollment. Participants who finished the biennial follow-up until December 31, 2017 were finally included in this analysis. The primary outcome was incident diabetes development. The pulse pressure variables were divided into quartiles (Q1-Q4), and the Kaplan-Meier curve was used to examine and estimate the cumulative incidence of new-onset diabetes among quartiles. Cox proportional hazards regression model was performed to explore the association between pulse pressure and the risk of new-onset diabetes in hypertensive patients. Results: During an average follow-up of 8.17 years, 6 617 new-onset diabetes were identified out of the 32 917 hypertensive patients with no history or evidence of diabetes in 2006-2007 check-up. Participants were classified into quartiles according to pulse pressure levels as follows: Q1 group(<41 mmHg (1mmHg=0.133kPa))(n=7 995); Q2 group(41-<51 mmHg) (n=8 196); Q3 group (51-<61 mmHg) (n= 8 270); Q4 group (≥61 mmHg) (n=8 456). The cumulative incidences of new-onset diabetes across the quartiles were 16.94%, 19.61%, 21.07%, and 22.33%, respectively, with the incidence density was 20.27, 23.20, 24.92, and 26.10 per 1 000 person-years, respectively. The cumulative incidence of new-onset diabetes increased in proportion with increasing pulse pressure levels (P<0.01 by the Log-rank test). After multivariate adjustment, compared with the first quartile, the hazard ratios for new-onset diabetes in the third and fourth quartiles were 1.13 (95%CI 1.04-1.22, P<0.01) and 1.14 (95%CI 1.05-1.24, P<0.01), respectively. The risk of new-onset diabetes increased 5%(HR=1.05, 95%CI 1.02-1.08, P<0.01) with the fractional pulse pressure increased per 1 SD (0.13). Findings from the three sensitivity analyses were consistent with the main results in this cohort. Conclusions: Pulse pressure at baseline is positively associated with the incidence of new-onset diabetes among hypertensive individuals, and pulse pressure is an independent risk factor for the development of diabetes in hypertensive patients.
