Association between changes in systolic blood pressure and incident diabetes in a community-based cohort study in Korea

Abstract

An association between hypertension and diabetes has been reported; however, the temporal relationship of blood pressure changes and incident diabetes has not been fully investigated in the general population. We examined whether increasing blood pressure is associated with the risk of developing diabetes among community-dwelling Korean adults. This study included 2225 participants (859 men and 1366 women) aged 27-87 years from the Korean Genome Epidemiology Study. The participants were free of diabetes and cardiovascular disease at baseline. Incident diabetes was defined as fasting blood glucose⩾126 mg dl-1 or hemoglobin a1c ⩾6.5% (48 mmol mol-1) at follow-up examination and/or a physician's diagnosis of diabetes during the follow-up period. The effects of the baseline level and change in blood pressure on the risk of incident diabetes were assessed by multivariate logistic regression analysis. During the mean follow-up of 2.6 years, new-onset diabetes was observed in 5.0% (43/859) of the men and 3.4% (47/1366) of the women. In the multivariate model, the baseline systolic blood pressure was not significantly associated with incident diabetes (adjusted odds ratio 0.93 per 10 mmHg, P=0.747). However, an increase in systolic blood pressure during the follow-up period was independently associated with incident diabetes (adjusted odds ratio 5.53 per 5 mmHg per year, P=0.002) after adjusting for the baseline blood pressure and other potential confounders. Increasing blood pressure, but not a high baseline blood pressure, was independently associated with the risk of diabetes in Korean adults.