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Usual Blood Pressure and Risk of New-Onset Diabetes: Evidence From 4.1 Million Adults and a Meta-Analysis of Prospective Studies

BACKGROUND: Reliable quantification of the association between blood pressure (BP) and risk of type 2 diabetes is lacking. OBJECTIVES: This study sought to determine the association between usual BP and risk of diabetes, overall and by participant characteristics. METHODS: A cohort of 4.1 million ad...

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Autores principales: Emdin, Connor A., Anderson, Simon G., Woodward, Mark, Rahimi, Kazem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Biomedical 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595710/
https://www.ncbi.nlm.nih.gov/pubmed/26429079
http://dx.doi.org/10.1016/j.jacc.2015.07.059
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author Emdin, Connor A.
Anderson, Simon G.
Woodward, Mark
Rahimi, Kazem
author_facet Emdin, Connor A.
Anderson, Simon G.
Woodward, Mark
Rahimi, Kazem
author_sort Emdin, Connor A.
collection PubMed
description BACKGROUND: Reliable quantification of the association between blood pressure (BP) and risk of type 2 diabetes is lacking. OBJECTIVES: This study sought to determine the association between usual BP and risk of diabetes, overall and by participant characteristics. METHODS: A cohort of 4.1 million adults, free of diabetes and cardiovascular disease, was identified using validated linked electronic health records. Analyses were complemented by a meta-analysis of prospective studies that reported relative risks of new-onset diabetes per unit of systolic blood pressure (SBP). RESULTS: Among the overall cohort, 20 mm Hg higher SBP and 10 mm Hg higher diastolic BP were associated with a 58% and a 52% higher risk of new-onset diabetes (hazard ratio: 1.58; 95% confidence interval [CI]: 1.56 to 1.59; and hazard ratio: 1.52; 95% confidence interval: 1.51 to 1.54), respectively. There was no evidence of a nadir to a baseline BP of 110/70 mm Hg. The strength of the association per 20 mm Hg higher SBP declined with age and with increasing body mass index. Estimates were similar even after excluding individuals prescribed antihypertensive or lipid-lowering therapies. Systematic review identified 30 studies with 285,664 participants and 17,388 incident diabetes events. The pooled relative risk of diabetes for a 20 mm Hg higher usual SBP across these studies was 1.77 (1.53 to 2.05). CONCLUSIONS: People with elevated BP are at increased risk of diabetes. The strength of the association declined with increasing body mass index and age. Further research should determine if the observed risk is modifiable.
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spelling pubmed-45957102015-10-28 Usual Blood Pressure and Risk of New-Onset Diabetes: Evidence From 4.1 Million Adults and a Meta-Analysis of Prospective Studies Emdin, Connor A. Anderson, Simon G. Woodward, Mark Rahimi, Kazem J Am Coll Cardiol Special Focus Issue: Population Health Promotion BACKGROUND: Reliable quantification of the association between blood pressure (BP) and risk of type 2 diabetes is lacking. OBJECTIVES: This study sought to determine the association between usual BP and risk of diabetes, overall and by participant characteristics. METHODS: A cohort of 4.1 million adults, free of diabetes and cardiovascular disease, was identified using validated linked electronic health records. Analyses were complemented by a meta-analysis of prospective studies that reported relative risks of new-onset diabetes per unit of systolic blood pressure (SBP). RESULTS: Among the overall cohort, 20 mm Hg higher SBP and 10 mm Hg higher diastolic BP were associated with a 58% and a 52% higher risk of new-onset diabetes (hazard ratio: 1.58; 95% confidence interval [CI]: 1.56 to 1.59; and hazard ratio: 1.52; 95% confidence interval: 1.51 to 1.54), respectively. There was no evidence of a nadir to a baseline BP of 110/70 mm Hg. The strength of the association per 20 mm Hg higher SBP declined with age and with increasing body mass index. Estimates were similar even after excluding individuals prescribed antihypertensive or lipid-lowering therapies. Systematic review identified 30 studies with 285,664 participants and 17,388 incident diabetes events. The pooled relative risk of diabetes for a 20 mm Hg higher usual SBP across these studies was 1.77 (1.53 to 2.05). CONCLUSIONS: People with elevated BP are at increased risk of diabetes. The strength of the association declined with increasing body mass index and age. Further research should determine if the observed risk is modifiable. Elsevier Biomedical 2015-10-06 /pmc/articles/PMC4595710/ /pubmed/26429079 http://dx.doi.org/10.1016/j.jacc.2015.07.059 Text en © 2015 Elsevier Inc. All rights reserved. https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) , which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.
spellingShingle Special Focus Issue: Population Health Promotion
Emdin, Connor A.
Anderson, Simon G.
Woodward, Mark
Rahimi, Kazem
Usual Blood Pressure and Risk of New-Onset Diabetes: Evidence From 4.1 Million Adults and a Meta-Analysis of Prospective Studies
title Usual Blood Pressure and Risk of New-Onset Diabetes: Evidence From 4.1 Million Adults and a Meta-Analysis of Prospective Studies
title_full Usual Blood Pressure and Risk of New-Onset Diabetes: Evidence From 4.1 Million Adults and a Meta-Analysis of Prospective Studies
title_fullStr Usual Blood Pressure and Risk of New-Onset Diabetes: Evidence From 4.1 Million Adults and a Meta-Analysis of Prospective Studies
title_full_unstemmed Usual Blood Pressure and Risk of New-Onset Diabetes: Evidence From 4.1 Million Adults and a Meta-Analysis of Prospective Studies
title_short Usual Blood Pressure and Risk of New-Onset Diabetes: Evidence From 4.1 Million Adults and a Meta-Analysis of Prospective Studies
title_sort usual blood pressure and risk of new-onset diabetes: evidence from 4.1 million adults and a meta-analysis of prospective studies
topic Special Focus Issue: Population Health Promotion
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595710/
https://www.ncbi.nlm.nih.gov/pubmed/26429079
http://dx.doi.org/10.1016/j.jacc.2015.07.059
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