Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories.
Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories.
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DOI：
10.1161/hypertensionaha.117.10546
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发表时间：
2018-03
期刊：
影响因子：
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通讯作者：
Ferrannini E
中科院分区：
文献类型：
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作者：
Tsimihodimos V;Gonzalez-Villalpando C;Meigs JB;Ferrannini E
2型糖尿病和高血压在人群中有重叠。在许多受试者中，糖尿病的发展以血浆葡萄糖值的相对快速增加为特征。在高血压的发展过程中是否会发生类似的现象尚不清楚。我们使用墨西哥城糖尿病研究（MCDS，一项以西班牙裔白人为基础的糖尿病研究）和Framingham后代研究（FOS，一项以社区为基础的非西班牙裔白人研究）的数据，对有或无糖尿病患者在高血压发展过程中的血压变化模式进行了分析。基线时的糖尿病是高血压发生的重要预测因子（FOS， OR=3.14 [95% CI= 2.17-4.54]），独立于性别、年龄、BMI和家族性糖尿病。相反，基线时的高血压是糖尿病发生的独立预测因子（FOS， OR=3.33 [95% CI= 2.50-4.44]）。在bbb60 %的转换者中，从血压正常进展到高血压的特征是血压值急剧升高，在3.5年内收缩压平均为20 mmHg （MCDS）。与非转换组相比，高血压和糖尿病转换组具有相同的代谢综合征表型（高胰岛素血症、更高的BMI、腰围、血压、心率和脉压、血脂异常）。总的来说，这两个族群的结果是相似的。我们得出结论：(1)高血压和糖尿病的发展随着时间的推移而相互跟踪；(2)血压从正常到高血压的转变以血压值的急剧升高为特征；(3)胰岛素抵抗是糖尿病前期和高血压前期的一个共同特征，是两种疾病发展的先决条件
Type 2 diabetes and hypertension overlap in the population. In many subjects, development of diabetes is characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs during the development of hypertension is not known. We analyzed the pattern of blood pressure (BP) changes during the development of hypertension in patients with or without diabetes using data from the Mexico City Diabetes Study (MCDS, a population-based study of diabetes in Hispanic Whites) and in the Framingham Offspring Study (FOS, a community-based study in non-Hispanic Whites) over a 7-year follow-up. Diabetes at baseline was a significant predictor of incident hypertension (in FOS, OR=3.14 [95% CI=2.17–4.54]) independently of gender, age, BMI, and familial diabetes. Conversely, hypertension at baseline was an independent predictor of incident diabetes (in FOS, OR=3.33 [95% CI=2.50–4.44]). In >60% of the converters, progression from normotension to hypertension was characterized by a steep increase in BP values, averaging 20 mmHg for systolic BP within 3.5 years (in MCDS). In comparison with the non-converters group, hypertension and diabetes converters shared a metabolic syndrome phenotype (hyperinsulinemia, higher BMI, waist girth, BP, heart rate and pulse pressure, dyslipidemia). Overall, results were similar in the two ethnic groups. We conclude that (1) development of hypertension and diabetes track each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BP values, and (3) insulin resistance is one common feature of both prediabetes and prehypertension, and an antecedent of progression to two respective disease states