scholarly journals Degree of Blood Pressure Control and Incident Diabetes Mellitus in Chinese Adults With Hypertension

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Yuanyuan Zhang ◽  
Jing Nie ◽  
Yan Zhang ◽  
Jianping Li ◽  
Min Liang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Propensity Scores ◽  
Fasting Glucose ◽  
Pressure Control ◽  
Incident Diabetes ◽  
Chinese Adults ◽  
Normal Fasting Glucose ◽  
Diagnosed Diabetes

Background The association between blood pressure (BP) control and incident diabetes mellitus remains unknown. We aim to investigate the association between degree of time‐averaged on‐treatment systolic blood pressure (SBP) control and incident diabetes mellitus in hypertensive adults. Methods and Results A total of 14 978 adults with hypertension without diabetes mellitus at baseline were included from the CSPPT (China Stroke Primary Prevention Trial). Participants were randomized double‐masked to daily enalapril 10 mg and folic acid 0.8 mg or enalapril 10 mg alone. BP measurements were taken every 3 months after randomization. The primary outcome was incident diabetes mellitus, defined as physician‐diagnosed diabetes mellitus, or use of glucose‐lowering drugs during follow‐up, or fasting glucose ≥126 mg/dL at the exit visit. Over a median of 4.5 years, a significantly higher risk of incident diabetes mellitus was found in participants with time‐averaged on‐treatment SBP 130 to <140 mm Hg (10.3% versus 7.4%; odds ratio [OR], 1.37; 95% CI, 1.15‒1.64), compared with those with SBP 120 to <130 mm Hg. Moreover, the risk of incident diabetes mellitus increased by 24% (OR, 1.24; 95% CI, 1.00‒1.53) and the incidence of regression to normal fasting glucose (<100 mg/dL) decreased by 29% (OR, 0.71; 95% CI, 0.57‒0.89) in participants with intermediate BP control (SBP/diastolic blood pressure, 130 to <140 and/or 80 to <90 mm Hg), compared with those with a tight BP control of <130/<80 mm Hg. Similar results were found when the time‐averaged BP were calculated using the BP measurements during the first 6‐ or 24‐month treatment period, or in the analysis using propensity scores. Conclusions In this non‐diabetic, hypertensive population, SBP control in the range of 120 to <130 mm Hg, compared with the 130 to <140 mm Hg, was associated with a lower risk of incident diabetes mellitus.

scholarly journals The effect of body mass index and fasting glucose on the relationship between blood pressure and incident diabetes mellitus: a 5-year follow-up study

2011 ◽  
Vol 34 (10) ◽  
pp. 1093-1097 ◽  
Author(s):  
Won Young Lee ◽  
Chang Hee Kwon ◽  
Eun Jung Rhee ◽  
Jeong Bae Park ◽  
Young Kwon Kim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Body Mass ◽  
Fasting Glucose ◽  
Incident Diabetes ◽  
Follow Up Study ◽  
The Relationship

scholarly journals Trajectories of energy intake distribution and subsequent risk of hyperglycemia among Chinese adults: findings from the China Health and Nutrition Survey (1997–2018)

2021 ◽  
Author(s):  
Xiaoyun Song ◽  
Huijun Wang ◽  
Chang Su ◽  
Zhihong Wang ◽  
Wenwen Du ◽  
...  
Keyword(s):  
Energy Intake ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Incident Diabetes ◽  
Chinese Adults ◽  
Increasing Trend ◽  
Group 3 ◽  
Subsequent Risk ◽  
Group 1

Abstract Aims Few studies have examined the secular trend of the energy intake distribution, and its effect on future risk of hyperglycemia. This study aims to describe trajectories of energy intake distribution over 12 years and relate them to subsequent risk of hyperglycemia over 9 years of follow-up. Methods Our study used ten waves of data from the CHNS survey, a population-based longitudinal survey in China, ongoing since 1989. We examined a cohort of adult participants who were free from diabetes but had at least three waves of dietary data from 1997 to 2009. We assessed energy intake using three consecutive 24 h recalls. We used these data to identify trajectory groups of energy intake distribution by multi-trajectory model based on energy intake proportions of breakfast, lunch, and dinner. We followed up participants for hyperglycemia, diabetes, and impaired fasting glucose for 9 years from 2009 to 2018. Outcomes were ascertained with fasting glucose, serum HbA1c, and self-report of diabetes and/or glucose-lowering medication. We estimated relative risk (RR) for hyperglycemia, diabetes, and impaired fasting glucose by identified trajectory groups using multilevel mixed-effects modified Poisson regression with robust (sandwich) estimation of variance. Gender difference was additionally examined. Results A total of 4417 participants were included. Four trajectory groups were identified, characterized and labeled by “Energy evenly distributed with steady trend group” (Group 1), “Dinner and lunch energy dominant with relatively steady trend group” (Group 2), “Dinner energy dominant with increasing trend and breakfast energy with declining trend group” (Group 3), and “breakfast and dinner energy dominant with increasing trend group” (Group 4). During 48,091 person-years, 1053 cases of incident hyperglycemia occurred, 537 cases of incident diabetes occurred, and 516 cases of impaired fasting glucose occurred. Compared with Group 1, Group 3 was associated with higher subsequent risk of incident hyperglycemia in 9 years of follow-up (RR = 1.28, 95% CI = 1.02, 1.61). No association was found for incident diabetes and impaired fasting glucose. Among males, Group 3 was associated with higher risk of incident hyperglycemia in 9 years of follow-up (RR = 1.44, 95% CI = 1.07, 1.94). No relationship was found in females. Conclusions Energy intake distribution characterized by over 40% of energy intake from dinner with a rising trend over years was associated with higher long-term risk of hyperglycemia in Chinese adults.

scholarly journals Blood Pressure Control and the Association With Diabetes Mellitus Incidence

Hypertension ◽  
2020 ◽  
Vol 75 (2) ◽  
pp. 331-338 ◽  
Author(s):  
Christianne L. Roumie ◽  
Adriana M. Hung ◽  
Gregory B. Russell ◽  
Jan Basile ◽  
Kathryn Evans Kreider ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Blood Glucose ◽  
Systolic Blood Pressure ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Incident Diabetes ◽  
Intensive Blood Pressure

The SPRINT (Systolic Blood Pressure Intervention Trial) demonstrated reduced cardiovascular outcomes. We evaluated diabetes mellitus incidence in this randomized trial that compared intensive blood pressure strategy (systolic blood pressure <120 mm Hg) versus standard strategy (<140 mm Hg). Participants were ≥50 years of age, with systolic 130 to 180 mm Hg and increased cardiovascular risk. Participants were excluded if they had diabetes mellitus, polycystic kidney disease, proteinuria >1 g/d, heart failure, dementia, or stroke. Postrandomization exclusions included participants missing blood glucose or ≥126 mg/dL (6.99 mmol/L) or on hypoglycemics. The outcome was incident diabetes mellitus: fasting blood glucose ≥126 mg/dL (6.99 mmol/L), diabetes mellitus self-report, or new use of hypoglycemics. The secondary outcome was impaired fasting glucose (100–125 mg/dL [5.55–6.94 mmol/L]) among those with normoglycemia (<100 mg/dL [5.55 mmol/L]). There were 9361 participants randomized and 981 excluded, yielding 4187 and 4193 participants assigned to intensive and standard strategies. There were 299 incident diabetes mellitus events (2.3% per year) for intensive and 251 events (1.9% per year) for standard, rates of 22.6 (20.2–25.3) versus 19.0 (16.8–21.5) events per 1000 person-years of treatment, respectively (adjusted hazard ratio, 1.19 [95% CI, 0.95–1.49]). Impaired fasting glucose rates were 26.4 (24.9–28.0) and 22.5 (21.1–24.1) per 100 person-years for intensive and standard strategies (adjusted hazard ratio, 1.17 [1.06–1.30]). Intensive treatment strategy was not associated with increased diabetes mellitus but was associated with more impaired fasting glucose. The risks and benefits of intensive blood pressure targets should be factored into individualized patient treatment goals. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01206062.

The Impact of Planned Visits on Patients with Type 2 Diabetes Mellitus

2009 ◽  
Vol 2 ◽  
pp. CMED.S2157
Author(s):  
Jim Nuovo
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Confidence Interval ◽  
Blood Pressure Control ◽  
Comparison Group ◽  
Pressure Control ◽  
Nurse Educator ◽  
The Mean

Objectives To investigate whether planned visits improve glycemic, blood pressure and lipid control among patients with type 2 diabetes mellitus (DM). Methods The study was conducted from July 2007 to February 2008 at a primary care clinic in Rancho Cordova, California. One hundred eighty-three patients were invited to come to a planned visit. On the day of the visit, they were provided a copy of their most recent test results and information on American Diabetes Association recommendations for A1C, lipid, and blood pressure control. Afterwards, they met with their physician for a 15-minute focused appointment. Finally, they met with a diabetic nurse educator. There was no subsequent contact with the nurse educator after the planned visit. We compared the baseline measurements to those from a follow-up visit with the primary care provider at a follow-up over a 6 month period. The comparison group in this study were those who did not accept the invitation for a planned visit. Their outcomes were monitored over the same time horizon. Results One hundred eighty-three patients attended one of a total of five planned visit sessions. There were 212 patients in the comparison group. There were no significant differences for the measured baseline characteristics. There were significant improvements in A1C, LDL-C, and diastolic blood pressure control in the planned visit group. The mean A1C change was –0.61% (95% confidence interval, –0.28, –0.70); P < 0.001). The mean LDL-C change was -8.8 mg/dL (95% confidence interval, –12.2, 6.1); P < 0.05. The mean diastolic blood pressure change was -2.0 mmHg (95% confidence interval, –4.7, 6.7); P < 0.05. Patients who participated in a planned visit also reported a significantly higher frequency of self-care behaviors and greater understanding about diabetes care. Discussion Planned visits led to improvements in glycemic, lipid and blood pressure control over a 6 month observation period. Patients attending planned visits also reported improvements in self-care behaviors and a greater understanding about diabetes care.

scholarly journals POS0815 CLINICAL CHARACTERISTICS, IMAGING PHENOTYPE, AND LONG-TERM OUTCOMES OF TAKAYASU ARTERITIS PATIENTS WITH HYPERTENSION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 661.1-661
Author(s):  
Y. Sun ◽  
L. Ma ◽  
H. Chen ◽  
C. Rongyi ◽  
L. Jiang
Keyword(s):  
Blood Pressure ◽  
Adverse Events ◽  
Clinical Features ◽  
Takayasu Arteritis ◽  
Pressure Control ◽  
Free Survival ◽  
The World ◽  
Cluster 2

Background:Hypertension occurred in 30-80% of TAK patients around the world. The occurrence of hypertension might severely worsen TAK prognosis. Nevertheless, data describing the specific imaging features in hypertensive TAK patients and the associations between hypertensive severity, blood pressure control status and long-term outcome were still lacking.Objectives:To investigate the characteristics and associations of hypertensive characteristics with adverse events-free survival in Takayasu arteritis (TAK) patients with hypertension.Methods:This research was based on a prospectively on-going observational cohort-East China Takayasu Arteritis (ECTA) cohort. In all, 618 TAK patients, who registered in the ECTA cohort up to December 2019, were enrolled. The main outcome was the adverse-events-free survival among hypertensive TAK patients during the follow-up ended on August 2020.Results:Totally, 204 (33.0%) patients suffered from hypertension, with 48 (23.5%), 62 (30.4%), and 94 (46.1%) mild, moderate, and severe hypertension, respectively. Cluster analysis indicated three imaging phenotypes for hypertensive TAK patients: Cluster 1: involvement of the abdominal aorta and/or renal artery (n=56, 27.5%); Cluster 2: involvement of the ascending aorta, thoracic aorta, and the aortic arch and its branches (n=38, 18.6%); Cluster 3: combined involvement of Cluster 1 and Cluster 2 (n=111, 54.4%). By the end of the follow-up, the blood pressure control rate was 50.8%, while the adverse-events-free survival was 67.9% in the entire hypertensive population. Multivariate Cox regression analysis indicated that well-controlled blood pressure (HR=2.13, 95%CI 1.32–3.78, p=0.047), co-existence of severe aortic valve regurgitation (HR=0.87, 95%CI 0.64–0.95, p=0.043), Cluster 1 (HR=0.69, 95%CI 0.48–0.92, p=0.017) and Cluster 3 (HR=0.72, 95%CI 0.43–0.94, p=0.048) imaging phenotype was associated with the adverse-events-free survival.Conclusion:Patients with controlled hypertension showed better adverse-events-free survival, while those with the Cluster 1 imaging phenotype were more likely to suffer from worse adverse-events-free survival. Hypertension occurred in 30-80% of TAK patients around the world. The occurrence of hypertension might severely worsen TAK prognosis.References:[1]Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol 2002; 55:481–6.[2]Watanabe Y, Miyata T, Tanemoto K. Current clinical features of new patients with Takayasu arteritis observed from a cross-country research in Japan: age and sex specificity. Circulation 2015; 132:1701–9.[3]Yilmaz N, Can M, Oner FA, et al. Impaired quality of life, disability and mental health in Takayasu’s arteritis. Rheumatol. (Oxford) 2013; 52:1898–904.[4]Laurent A, Julien H, Nicolas L, et al. Takayasu arteritis in France: a single-center retrospective study of 82 cases comparing white, North African, and black patients. Medicine 2010; 89:1–17.[5]Mwipatayi BP, Jeffery PC, Beningfield SJ, et al. Takayasu arteritis: clinical features and management: report of 272 cases. ANZ J Surg 2005; 75:110–7.Disclosure of Interests:None declared

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