Abstract
Objective. To determine risk factors for the development of hypertension among African-Americans living with type 1 diabetes. Methods. African-Americans with type 1 diabetes (n = 483) participated in a 6-year followup. At both baseline and followup blood pressure was measured twice in both sitting and standing positions using a standard protocol. Patients had a structured clinical interview, ocular examination, retinal photographs, and blood and urine assays and completed the Hostility and Direction of Hostility Questionnaire (HDHQ) and the Beck Depression Inventory (BDI). Results. Of the 280 diabetic patients with no hypertension at baseline, 82 (29.3%) subsequently developed hypertension over the 6-year followup. Baseline older age, longer duration of diabetes, family history of hypertension, greater mean arterial blood pressure, overt proteinuria, increasing retinopathy severity, peripheral neuropathy, smoking, and higher hostility scores were significantly associated with the development of hypertension. Multivariate analyses showed that higher hostility scores and overt proteinuria were significantly and independently associated with the development of hypertension in this population. Conclusions. The development of hypertension in African-Americans living with type 1 diabetes appears to be multifactorial and includes both medical (overt proteinuria) as well as psychological (high hostility) risk factors.
Highlights
Persons living with diabetes have a prevalence of systemic hypertension twice as high as persons without diabetes [1,2,3,4,5]
We found that a high percentage (29.3%) of 280 African-Americans with type 1 diabetes, who had no hypertension at baseline, subsequently developed hypertension over a 6-year follow-up period
The apparent higher risk of hypertension in African-Americans compared with whites, in those with diabetes, is incompletely understood though it is noteworthy that the etiology of hypertension is generally thought to be multifactorial and to include medical, lifestyle, psychological, and genetic factors [13, 17, 31, 49]
Summary
Persons living with diabetes have a prevalence of systemic hypertension twice as high as persons without diabetes [1,2,3,4,5]. Hypertension is an important problem in persons living with diabetes because it is strongly associated with the development of the major complications of diabetes— retinopathy, nephropathy, and cardiovascular disease [6,7,8,9,10]. As such, it is a major cause of morbidity and mortality among persons living with diabetes [11, 12]. There is, no longitudinal study examining medical and psychological risk factors for the development of hypertension in a large group of AfricanAmericans living with type 1 diabetes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
