Patients with uncontrolled hypertension are twice as likely to develop diabetes as are those whose blood pressure is well controlled, a prospective study has found.
The study followed 1,754 patients enrolled in a hypertension clinic network in Naples, Italy, for up to 3.5 years. At baseline, the patients' mean age was 52 years, and all had normal fasting glucose levels. Blood pressure was considered uncontrolled if it exceeded 140/90 mm Hg while the patient was taking antihypertensive medication.
Uncontrolled hypertension occurred in 712 (41%) of the patients. Those with uncontrolled hypertension were significantly younger (51 vs. 53 years), and had a significantly higher heart rate than did those with controlled hypertension, Dr. Raffaele Izzo of Federico II University Hospital in Naples, and his colleagues reported (Diabetes Care 2009;32:845-50).
During follow-up, 109 (6%) of the patients developed diabetes. These patients were older (56 vs. 52 years), and had significantly higher body mass index, fasting glucose levels, uric acid, and triglycerides. They were significantly more likely to have metabolic syndrome (61% vs 21%).
After the researchers controlled for age at the time of first visit, gender, baseline systolic blood pressure, family history, fasting glucose, BMI, and physical activity, the rate of diabetes was twice as high among those with uncontrolled blood pressure. The risk of diabetes tripled when the regression model replaced fasting glucose and BMI with the modified Adult Treatment Panel-III definition of metabolic syndrome.
The authors reported no conflicts of interest.