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Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study

OBJECTIVE: Diabetes and hypertension often co-occur and share risk factors. Hypertension is known to predict diabetes. However, hyperglycemia also may be independently associated with future development of hypertension. We investigated glycated hemoglobin (HbA(1c)) as a predictor of incident hyperte...

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Autores principales: Bower, Julie K., Appel, Lawrence J., Matsushita, Kunihiro, Young, J. Hunter, Alonso, Alvaro, Brancati, Frederick L., Selvin, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329825/
https://www.ncbi.nlm.nih.gov/pubmed/22432110
http://dx.doi.org/10.2337/dc11-2248
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author Bower, Julie K.
Appel, Lawrence J.
Matsushita, Kunihiro
Young, J. Hunter
Alonso, Alvaro
Brancati, Frederick L.
Selvin, Elizabeth
author_facet Bower, Julie K.
Appel, Lawrence J.
Matsushita, Kunihiro
Young, J. Hunter
Alonso, Alvaro
Brancati, Frederick L.
Selvin, Elizabeth
author_sort Bower, Julie K.
collection PubMed
description OBJECTIVE: Diabetes and hypertension often co-occur and share risk factors. Hypertension is known to predict diabetes. However, hyperglycemia also may be independently associated with future development of hypertension. We investigated glycated hemoglobin (HbA(1c)) as a predictor of incident hypertension. RESEARCH DESIGN AND METHODS: We conducted a prospective analysis of 9,603 middle-aged participants in the Atherosclerosis Risk in Communities Study without hypertension at baseline. Using Cox proportional hazards models, we estimated the association between HbA(1c) at baseline and incident hypertension by two definitions 1) self-reported hypertension during a maximum of 18 years of follow-up and 2) measured blood pressure or hypertension medication use at clinic visits for a maximum of 9 years of follow-up. RESULTS: We observed 4,800 self-reported and 1,670 visit-based hypertension cases among those without diagnosed diabetes at baseline. Among those with diagnosed diabetes at baseline, we observed 377 self-reported and 119 visit-based hypertension cases. Higher baseline HbA(1c) was associated with an increased risk of hypertension in subjects with and without diabetes. Compared with nondiabetic adults with HbA(1c) <5.7%, HbA(1c) in the prediabetic range (5.7–6.4%) was independently associated with incident self-reported hypertension (hazard ratio 1.14 [95% CI 1.06–1.23]) and visit-detected hypertension (1.17 [1.03–1.33]). CONCLUSIONS: We observed that individuals with elevated HbA(1c), even without a prior diabetes diagnosis, are at increased risk of hypertension. HbA(1c) is a known predictor of incident heart disease and stroke. Our results suggest that the association of HbA(1c) with cardiovascular risk may be partially mediated by the development of hypertension.
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spelling pubmed-33298252013-05-01 Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study Bower, Julie K. Appel, Lawrence J. Matsushita, Kunihiro Young, J. Hunter Alonso, Alvaro Brancati, Frederick L. Selvin, Elizabeth Diabetes Care Original Research OBJECTIVE: Diabetes and hypertension often co-occur and share risk factors. Hypertension is known to predict diabetes. However, hyperglycemia also may be independently associated with future development of hypertension. We investigated glycated hemoglobin (HbA(1c)) as a predictor of incident hypertension. RESEARCH DESIGN AND METHODS: We conducted a prospective analysis of 9,603 middle-aged participants in the Atherosclerosis Risk in Communities Study without hypertension at baseline. Using Cox proportional hazards models, we estimated the association between HbA(1c) at baseline and incident hypertension by two definitions 1) self-reported hypertension during a maximum of 18 years of follow-up and 2) measured blood pressure or hypertension medication use at clinic visits for a maximum of 9 years of follow-up. RESULTS: We observed 4,800 self-reported and 1,670 visit-based hypertension cases among those without diagnosed diabetes at baseline. Among those with diagnosed diabetes at baseline, we observed 377 self-reported and 119 visit-based hypertension cases. Higher baseline HbA(1c) was associated with an increased risk of hypertension in subjects with and without diabetes. Compared with nondiabetic adults with HbA(1c) <5.7%, HbA(1c) in the prediabetic range (5.7–6.4%) was independently associated with incident self-reported hypertension (hazard ratio 1.14 [95% CI 1.06–1.23]) and visit-detected hypertension (1.17 [1.03–1.33]). CONCLUSIONS: We observed that individuals with elevated HbA(1c), even without a prior diabetes diagnosis, are at increased risk of hypertension. HbA(1c) is a known predictor of incident heart disease and stroke. Our results suggest that the association of HbA(1c) with cardiovascular risk may be partially mediated by the development of hypertension. American Diabetes Association 2012-05 2012-04-11 /pmc/articles/PMC3329825/ /pubmed/22432110 http://dx.doi.org/10.2337/dc11-2248 Text en © 2012 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. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Bower, Julie K.
Appel, Lawrence J.
Matsushita, Kunihiro
Young, J. Hunter
Alonso, Alvaro
Brancati, Frederick L.
Selvin, Elizabeth
Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study
title Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study
title_full Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study
title_fullStr Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study
title_full_unstemmed Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study
title_short Glycated Hemoglobin and Risk of Hypertension in the Atherosclerosis Risk in Communities Study
title_sort glycated hemoglobin and risk of hypertension in the atherosclerosis risk in communities study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329825/
https://www.ncbi.nlm.nih.gov/pubmed/22432110
http://dx.doi.org/10.2337/dc11-2248
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