Dataset Information

Higher blood pressure predicts diabetes and enhances long-term risk of cardiovascular disease events in individuals with impaired glucose tolerance: Twenty-three-year follow-up of the Daqing diabetes prevention study.

ABSTRACT:

Background

Hypertension is more prevalent in subjects with impaired glucose tolerance (IGT), but whether higher blood pressure per se or the mild hyperglycemia in combination with the hypertension enhanced the risk of cardiovascular disease (CVD) remains unclear.

Methods

Five hundred and sixty-eight participants with IGT in the original Daqing diabetes prevention study, 297 with hypertension (HBP) and 271 without hypertension (NBP), were enrolled in 1986 and the intervention phase lasted for 6 years. In 2009, they were followed up to assess the outcomes of cardiovascular events (including stroke and myocardial infarction) and incidence of diabetes.

Results

Over 23 years, the incidence of diabetes was 93.9/1000 person-years in HBP and 72.2/1000 person-years in the NBP group, with an age- and sex-adjusted hazard ratio of 1.26 (95% confidence interval [CI], 1.04-1.54, P = 0.02). The yearly incidence of CVD events was 27.7/1000 person-years and 16.6/1000 person-years, indicating a 35% higher risk in HBP than in the NBP group (95% CI, 1.01-1.81; P = 0.04). Cox proportional hazard analysis showed that a 10-mm Hg increase of the baseline systolic blood pressure was associated with 9% increased risk of the development of diabetes (P = 0.02), together with a 7% higher risk of the CVD events (P = 0.02).

Conclusions

Hypertension predicted diabetes and enhances long-term risk of CVD events in patients with IGT. An individualized strategy that targets hypertension as well as hyperglycemia is needed for diabetes and its cardiovascular complications.

SUBMITTER: Li X

PROVIDER: S-EPMC6618010 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Higher blood pressure predicts diabetes and enhances long-term risk of cardiovascular disease events in individuals with impaired glucose tolerance: Twenty-three-year follow-up of the Daqing diabetes prevention study.

Li Xiaojue X Wang Jinping J Shen Xiaoxia X An Yali Y Gong Qiuhong Q Li Hui H Zhang Bo B Shuai Ying Y Chen Yanyan Y Hu Yinghua Y Li Guangwei G

Journal of diabetes 20190203 7

<h4>Background</h4>Hypertension is more prevalent in subjects with impaired glucose tolerance (IGT), but whether higher blood pressure per se or the mild hyperglycemia in combination with the hypertension enhanced the risk of cardiovascular disease (CVD) remains unclear.<h4>Methods</h4>Five hundred and sixty-eight participants with IGT in the original Daqing diabetes prevention study, 297 with hypertension (HBP) and 271 without hypertension (NBP), were enrolled in 1986 and the intervention phase ...[more]

PMID: 30556339

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Project description:ImportancePrevious studies have shown that Jinlida (JLD) granules, an approved treatment for type 2 diabetes in China, can reduce blood glucose level, reduce glycated hemoglobin (HbA1c), and improve insulin resistance in people with type 2 diabetes.ObjectiveTo evaluate the effect of long-term administration of JLD vs placebo on the incidence of diabetes in participants with impaired glucose tolerance (IGT) and multiple metabolic abnormalities.Design, setting, and participantsThis multicenter, double-blind, placebo-controlled randomized clinical trial (FOCUS) was conducted across 35 centers in 21 cities in China from June 2019 to February 2023. Individuals aged 18 to 70 years with IGT and multiple metabolic abnormalities were enrolled.InterventionParticipants were randomly allocated 1:1 to receive JLD or placebo (9 g, 3 times per day, orally). They continued this regimen until they developed diabetes, withdrew from the study, were lost to follow-up, or died.Main outcomes and measuresThe primary outcome was the occurrence of diabetes, which was determined by 2 consecutive oral glucose tolerance tests. Secondary outcomes included waist circumference; fasting and 2-hour postprandial plasma glucose levels; HbA1c; fasting insulin level; homeostatic model assessment for insulin resistance (HOMA-IR); total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels; ankle-brachial index; and carotid intima-media thickness.ResultsA total of 889 participants were randomized, of whom 885 were in the full analysis set (442 in the JLD group; 443 in the placebo group; mean [SD] age, 52.57 [10.33] years; 463 [52.32%] female). Following a median observation period of 2.20 years (IQR, 1.27-2.64 years), participants in the JLD group had a lower risk of developing diabetes compared with those in the placebo group (hazard ratio, 0.59; 95% CI, 0.46-0.74; P < .001). During the follow-up period, the JLD group had a between-group difference of 0.95 cm (95% CI, 0.36-1.55 cm) in waist circumference, 9.2 mg/dL (95% CI, 5.4-13.0 mg/dL) in 2-hour postprandial blood glucose level, 3.8 mg/dL (95% CI, 2.2-5.6 mg/dL) in fasting blood glucose level, 0.20% (95% CI, 0.13%-0.27%) in HbA1c, 6.6 mg/dL (95% CI, 1.9-11.2) in total cholesterol level, 4.3 mg/dL (95% CI, 0.8-7.7 mg/dL) in low-density lipoprotein cholesterol level, 25.7 mg/dL (95% CI, 15.9-35.4 mg/dL) in triglyceride levels, and 0.47 (95% CI, 0.12-0.83) in HOMA-IR compared with the placebo group. After 24 months of follow-up, the JLD group had a significant improvement in ankle-brachial index and waist circumference compared with the placebo group.Conclusions and relevanceThe findings suggest that JLD can reduce the risk of diabetes in participants with IGT and multiple metabolic abnormalities.Trial registrationChinese Clinical Trial Register: ChiCTR1900023241.

Dataset Information

Higher blood pressure predicts diabetes and enhances long-term risk of cardiovascular disease events in individuals with impaired glucose tolerance: Twenty-three-year follow-up of the Daqing diabetes prevention study.

Background

Methods

Results

Conclusions

Publications

Higher blood pressure predicts diabetes and enhances long-term risk of cardiovascular disease events in individuals with impaired glucose tolerance: Twenty-three-year follow-up of the Daqing diabetes prevention study.

Similar Datasets

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