Abstract
BackgroundReliable quantification of the relationship between hypertension and diabetes risk is limited, especially among Chinese people. We aimed to investigate the association between hypertension and the risk of diabetes in a large cohort of the Chinese population.MethodsThis was a retrospective propensity score-matched cohort study among 211,809 Chinese adults without diabetes at baseline between 2010 and 2016. The target independent and dependent variable were hypertension at baseline and incident diabetes during follow-up respectively. The propensity score matching using a non-parsimonious multivariable logistic regression was conducted to balance the confounders between 28,711 hypertensive patients and 28,711 non-hypertensive participants. The doubly robust estimation method was used to investigate the association between hypertension and diabetes.ResultsIn the propensity-score matching cohort, diabetes risk increased by 11.0% among hypertensive patients (HR = 1.110, 95% confidence interval (CI): 1.031–1.195, P = 0.00539). And diabetes risk dropped to 8.3% among hypertensive subjects after adjusting for the propensity score (HR = 1.083, 95%CI: 1.006–1.166, P = 0.03367). Compared to non-hypertensive participants with low propensity score, the risk of incident diabetes increased by 2.646 times among hypertensive patients with high propensity score (HR = 3.646, 95%CI: 2.635–5.045, P < 0.0001).ConclusionHypertension was associated with an 11.0% increase in the risk of developing diabetes in Chinese adults. And the figure dropped to 8.3% after adjusting the propensity score. Additionally, compared to non-hypertensive participants with low propensity scores, the risk of incident diabetes increased by 2.646 times among hypertensive patients with high propensity scores.
Highlights
Reliable quantification of the relationship between hypertension and diabetes risk is limited, especially among Chinese people
We found that participants with hypertension generally had higher age, Body mass index (BMI), Fasting plasma glucose (FPG), Total cholesterol (TC), TG, Alanine aminotransferase (ALT) and Serum urea nitrogen (BUN)
Hypertension had a significant correlation with incident diabetes (HR = 1.110, 95% confidence interval (CI): 1.031–1.195, P = 0.00539)
Summary
Reliable quantification of the relationship between hypertension and diabetes risk is limited, especially among Chinese people. Diabetes mellitus is an important global public health problem with high morbidity and disability. The World Health Organization estimated that the prevalence of diabetes in adults was 8.5% in 2016 [1]. The global diabetes prevalence in 2019 was estimated to be 9.3% (463 million people), rising to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045 [2]. It is a debilitating chronic epidemic with potentially various complications. The high morbidity of diabetes has important social, economic and developmental implications worldwide
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