WASHINGTON — People of all ages with type 2 diabetes are at increased risk for essential hypertension, but the relationship is exceptionally strong in children and adolescents, Dr. Scott J. Jacober and his associates reported in a poster at the annual scientific sessions of the American Diabetes Association.
Essential hypertension and type 2 diabetes often coexist, but this retrospective study of a nationwide electronic medical records database is believed to be the first to examine the prevalence of essential hypertension by age group in individuals with and without diabetes, said Dr. Jacober, who was with Lilly Research Laboratories, Indianapolis, at the time of the study.
The database contained more than 4 million patients, and the study population, from 49 states during 1996–2005, comprised 231,492 individuals with a physician's diagnosis of type 2 diabetes; patients with type 1 diabetes were excluded. The study also included 1,219,047 people without type 2 diabetes. Overall, essential hypertension was diagnosed in 63% of patients with type 2 diabetes, compared with 40% of those without.
The difference was striking in children younger than age 12 years. Essential hypertension was present in 26.3% of the 219 with type 2 diabetes, compared with 0.5% of the 49,984 without, for an unadjusted odds ratio of 56.1.
Even after adjustment for age, gender, geographic region, and five comorbid conditions (obesity, hyperlipidemia, nephritis, ischemic heart disease, and other forms of heart disease), children aged 0–11 years with type 2 diabetes still were more than 20 times more likely than those without to have essential hypertension, Dr. Jacober and his colleagues reported.
Among adolescents aged 12–19 years, essential hypertension was present in 9.7% of the 691 with type 2 diabetes vs. 1.8% of the 61,129 without. In this age group, the unadjusted odds ratio was 4.4 and the adjusted odds ratio was 2.3, also highly significant.
Differences were less dramatic among adults, but still were statistically significant for all age groups even after adjustment. Among the 2,808 young adults aged 20–29, essential hypertension was present in 21% of those with type 2 diabetes vs. 7.3% of those without, with a 50% increased risk for essential hypertension after adjustment.
Overall, the prevalence of essential hypertension among the diabetics increased by decade of life from 36% at ages 30–39 to 70% at ages 70–79, dropping slightly thereafter to 67% among people over 80 years of age. Among the nondiabetics, essential hypertension was present in 19.5% of the 30- to 39-year-olds, rising to 60% for those aged 70–79, and again dropping slightly thereafter to 58%.