Association of hypertension onset age with diabetes
GAO Hui1, ZHU Xuting1, ZHANG Lei1, XIA Qinghua1, WANG Yingquan2, ZHANG Yanping3, XU Jiangmin4, SHI Yue5, SHI Wuyue6, JIANG Yu1, WAN Jinbao7
1. Department of Chronic Non-Communicable Disease Control and Prevention, Changning District Center for Disease Control and Prevention, Shanghai 200051, China; 2. Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China; 3. Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200052, China; 4. Shanghai Changning Tianshan Traditional Chinese Medicine Hospital, Shanghai 200051, China; 5. Hongqiao Community Health Service Center, Changning District, Shanghai 200051, China; 6. Zhoujiaqiao Community Health Service Center, Changning District, Shanghai 200051, China; 7. Baoshan District Center for Disease Control and Prevention, Shanghai 201901, China
Abstract：Objective To examine the association of hypertension onset age with diabetes, so as to provide insights into reducing the the risk of cardiovascular events. Methods Permanent residents aged 35 to 75 years were selected through the program of early screening and comprehensive intervention for the high-risk cardiovascular disease population in Changning District and Baoshan District, Shanghai Municipality from 2016 to 2020. Demographic information, disease history, hypertension onset age, blood pressure and fasting blood glucose were collected through questionnaire surveys, physical examination and laboratory tests. The residents were divided into four groups based on the onset age of hypertension: <45, 45-<55, 55-<65 and ≥65 years old, and the residents with normal blood pressure were selected as control. The association of hypertension onset age with prediabetes and diabetes were identified using a multivariable logistic regression model. Results A total of 25 228 residents were recruited, including 8 753 males (34.70%) and 16 475 females (65.30%). The prevalence of hypertension was 43.80%. There were 1 779, 3 274, 3 781 and 2 217 cases with hypertension onset age of <45, 45-<55, 55-<65 and ≥65 years old, respectively, and 14 177 residents with normal blood pressure. The prevalence of prediabetes and diabetes were 24.01% and 11.29%, respectively. Multivariable logistic regression analysis showed that after adjusting for confounding factors such as gender, marital status and educational level, compared with the normal blood pressure group, the risk of prediabetes was higher in the hypertension onset age groups of <45 (OR=1.345, 95%CI: 1.164-1.553), 45-<55 (OR=1.365, 95%CI: 1.212-1.536) and 55-<65 years old (OR=1.376, 95%CI: 1.239-1.527), and the risk of diabetes was higher in the hypertension onset age groups of <45 (OR=2.302, 95%CI: 1.906-2.775), 45-<55 (OR=2.349, 95%CI: 2.016-2.734), 55-<65 (OR=1.909, 95%CI: 1.667-2.184) and ≥65 years old (OR=1.315, 95%CI: 1.131-1.526). Conclusion There are statistically significant associations between hypertension onset age with prediabetes and diabetes.
[1] SUN H,SAEEDI P,KARURANGA S,et al,IDF diabetes atlas:global,regional and country-level diabetes prevalence estimates for2021 and projections for 2045[J/OL].Diabetes Res Clin Pract,2022[2024-10-12].https://pubmed.ncbi.nlm.nih.gov/34879977.DOI:10.1016/j.diabres.2021.109119. [2] 龚海英,邢瑞婷,刘晓芬,等.房山区居民糖尿病患病率、知晓率、治疗率和控制率分析[J].预防医学,2024,36(7):616-621. [3] 李尉键,方伟,蔡泽锋,等.高血压人群脉压与新发糖尿病的关系探讨[J].中华心血管病杂志,2021,49(7):673-679. [4] 沈妙言,张岚,祝淑珍,等.不同血压水平与糖尿病前期的关联性[J].中华流行病学杂志,2022,43(12):1939-1944. [5] WANG C,YUAN Y,ZHENG M Y,et al.Association of age of onset of hypertension with cardiovascular diseases and mortality[J].J Am Coll Cardiol,2020,75(23):2921-2930. [6] 中国老年医学学会高血压分会,北京高血压防治协会,国家老年疾病临床医学研究中心(中国人民解放军总医院,首都医科大学宣武医院).中国老年高血压管理指南2023[J].中华高血压杂志,2023,31(6):508-538. [7] 中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会,等.中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1):24-56. [8] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].国际内分泌代谢杂志,2021,41(5):482-548. [9] SUVILA K,MCCABE E L,LIMA J,et al.Self-reported age of hypertension onset and hypertension-mediated organ damage in middle-aged individuals[J].Am J Hypertens,2020,33(7):644-651. [10] FERRANNINI E,CUSHMAN W C.Diabetes and hypertension:the bad companions[J].Lancet,2012,380(9841):601-610. [11] WU Y T,SONG L,LIU X X,et al.Time-cumulated blood pressure exposure and incident impairment of glucose tolerance and diabetes mellitus[J].BMC Cardiovasc Disord,2017,17(1):1-10. [12] 张洁,费方荣,胡如英,等.浙江省慢性病主要危险因素的归因疾病负担研究[J].预防医学,2022,34(6):541-546. [13] 金丹,张开月,王静.家庭固体燃料使用与糖尿病、高血压风险的研究进展[J].预防医学,2024,36(8):679-682. [14] YAMADA Y,KATO K,OGURI M,et al.Identification of four genes as novel susceptibility loci for early-onset type 2 diabetes mellitus,metabolic syndrome,or hyperuricemia[J].Biomed Rep,2018,9(1):21-36. [15] 李翔,严同,许樟荣.糖尿病和高血压[J].中华糖尿病杂志,2021,13(7):740-745. [16] TSIMIHODIMOS V,GONZALEZ-VILLALPANDO C,MEIGS J B,et al.Hypertension and diabetes mellitus:coprediction and time trajectories[J].Hypertension,2018,71(3):422-428. [17] FAERCH K,WITTE D R,TABAK A G,et al.Trajectories of cardiometabolic risk factors before diagnosis of three subtypes of type 2 diabetes:a post-hoc analysis of the longitudinal Whitehall Ⅱ cohort study[J].Lancet Diabetes Endocrinol,2013,1(1):43-51. [18] TABAK A G,HERDER C,RATHMANN W,et al.Prediabetes:a high-risk state for diabetes development[J].Lancet,2012,379(9833):2279-2290.
