Abstract

Background: Hypertension is a well-known risk factor to increase the risk of cardiovascular and metabolic diseases in diabetic patients, but the relationship between hypertension and the development of new-onset diabetes mellitus (DM) is not clear. We evaluated the impact of hypertension on the development of new-onset DM based on 5-year clinical follow up results in Asian population.

Methods: From January 2004 to September 2007, a total of 4,071 consecutive hypertensive patients who did not have DM were enrolled. New-onset DM was defined as having a fasting blood glucose ≥126mg/dL or HbA1c ≥6.5%. Baseline characteristics between the hypertensive and normotensive groups were propensity score matched (PSM, C-statics=0.723). 5-year cumulative incidence of new-onset DM was compared between the two groups.

Results: At baseline, patients in the hypertensive group showed a higher prevalence of cerebrovascular accidents. The normotensive group had a higher prevalence of coronary artery disease, cardiac arrhythmia, and smoking history. After 5 years, there was no difference in the incidence of new-onset DM showed between the 2 groups. Adjusted with cox-regression analysis, hypertension was shown to be a significant independent predictor of new-onset DM (OR 1.30, 95% CI 1.01 – 1.68, p=0.037). After propensity score matching (AUC=0.723), there was a higher incidence of new-onset DM in the hypertensive group (11.4% vs. 7.9%, p=0.006) at 5 years. Adjusted with cox-regression analysis, hypertension still remained independent predictor of new-onset DM (OR 1.36, 95% CI 1.00 – 1.84, p=0.045).

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Conclusions: In our study, hypertension is shown to be an independent predictor of new-onset DM at 5 years clinical follow up, suggesting hypertensive patients should be carefully managed and monitored for new-onset DM.