Arterial stiffness was better able to predict diabetes than hypertension was, according to results of a study published in the journal Hypertension.

Data for this analysis were sourced from the Kailuan study, which is an ongoing prospective study in China that has been evaluating participants for health status biennially since 2010. Individuals (N=11,156) who were evaluated between 2010 and 2014 at baseline were assessed for diabetes at follow-up on the basis of hypertension and arterial stiffness, measured by brachial-ankle pulse wave velocity.

Participants had ideal vascular function (n=4399), normotension with elevated arterial stiffness (n=2706), hypertension with normal arterial stiffness (n=839), and hypertension with elevated arterial stiffness (n=3212). Cohorts were aged mean 45.37 to 57.58 years and 34.76% to 78.09% were men.


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During a median follow-up of 6.16 years, 6.88% were diagnosed with diabetes. Stratified by group, 3.14% of the ideal vascular function cohort, 7.69% of the normotension with elevated arterial stiffness cohort, 7.27% of the hypertension with normal arterial stiffness cohort, and 11.20% of the hypertension with elevated arterial stiffness cohort developed diabetes.

Compared with the ideal vascular function cohort, risk for diabetes was highest among the hypertension with elevated arterial stiffness cohort (adjusted hazard ratio [aHR], 2.17; 95% CI, 1.63-2.89) followed by the normotension with elevated arterial stiffness cohort (aHR, 2.06; 95% CI, 1.63-2.60) and hypertension with normal arterial stiffness cohort (aHR, 1.34; 95% CI, 1.02-1.91).

Similar findings were observed in a sensitivity analysis using isolated systolic or diastolic hypertension.

In a predictive model using age, gender, BMI, heart rate, smoking status, alcohol consumption, dyslipidemia, cholesterol, uric acid, high sensitivity C-reactive protein, and estimated glomerular filtration rate, the accuracy of predicting diabetes increased from a C statistic of 0.690 to 0.695 with the addition of hypertension (P =.0807), 0.707 with the addition of arterial stiffness (P =.0003), and 0.709 with the addition of hypertension and arterial stiffness (P =.0001).

This study may have underestimated diabetes, as oral glucose tolerance and glycated hemoglobin levels were not routinely evaluated.

“Diabetes is associated with not only hypertension but also [arterial stiffness],” the study authors wrote. “Additionally, [arterial stiffness] shows a better predictive ability than hypertension in predicting diabetes.”

Reference

Tian X, Zuoe Y, Chene S, et al. Hypertension, arterial stiffness, and diabetes: a prospective cohort study. Hypertension. Published online on May 16, 2022. doi:10.1161/HYPERTENSIONAHA.122.19256