Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories
Himanshu Garg, Nikhil Batra, Gaurav Singh, Anshaj Mujral
Abstract
Type 2 diabetes mellitus and hypertension overlap in the population. In many subjects, development of diabetes mellitusis characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs duringthe development of hypertension is not known. We analyzed the pattern of blood pressure (BP) changes during thedevelopment of hypertension in patients with or without diabetes mellitus using data from the MCDS and in the FOSduring a 7-year follow-up. Diabetes mellitus at baseline was a significant predictor of incident hypertension (in FOS,odds ratio, 3.14; 95% confidence interval, 2.17–4.54) independently of sex, age, body mass index, and familial diabetesmellitus. Conversely, hypertension at baseline was an independent predictor of incident diabetes mellitus. In comparisonwith the nonconverters group, hypertension and diabetes mellitus converters shared a metabolic syndrome phenotype(hyperinsulinemia, higher body mass index, waist girth, BP, heart rate and pulse pressure, and dyslipidemia). Overall,results were similar in the 2 ethnic groups. We conclude that (1) development of hypertension and diabetes mellitustrack each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BPvalues, and (3) insulin resistance is one common feature of both prediabetes and prehypertension and an antecedent ofprogression to 2 respective disease states.