European Heart Journal Advance Access originally published online on October 9, 2007
European Heart Journal 2007 28(23):2937-2943; doi:10.1093/eurheartj/ehm400
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Blood pressure and risk of developing type 2 diabetes mellitus: The Women's Health Study
1 Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue East, Boston, MA 02215, USA
2 Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
3 Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
4 Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
5 Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA, USA
Received 3 May 2007; revised 16 July 2007; accepted 23 August 2007; online publish-ahead-of-print 9 October 2007.
* Corresponding author. Tel: +1 617 525 6856; fax: +1 617 734 1437. E-mail address: conend{at}uhbs.ch
See page 2832 for the editorial comment on this article (doi:10.1093/eurheartj/ehm494)
Aims: To examine the relationship of blood pressure (BP) and BP progression with the subsequent development of type 2 diabetes.
Methods and results: We performed a prospective cohort study among 38 172 women free of diabetes and cardiovascular disease at baseline. Women were classified into four categories according to self-reported baseline BP (<120/75 mmHg, 120–129/75–84 mmHg, 130–139/85–89 mmHg and hypertension) and were further classified according to progression to a higher BP category during the first 48 months of follow-up. The main outcome measure was time to incident type 2 diabetes. During 10.2 years of follow-up, 1672 women developed type 2 diabetes. The multivariable adjusted hazard ratios (HRs) (95% confidence interval) for incident diabetes across BP categories were 0.66 (0.55–0.80), 1.0 (referent), 1.45 (1.23–1.71), and 2.03 (1.77–2.32) (P-value for trend <0.0001). Stratification by body mass index revealed similar results. Adjusted HRs (95% confidence intervals) for incident diabetes after 48 months among women who had no BP progression, women with BP progression but remaining normotensive, and women who developed hypertension during the first 48 months were 1.0, 1.26 (0.97–1.64), and 1.64 (1.33–2.02) compared with 2.39 (1.95–2.93) in women with baseline hypertension (P-value for trend <0.0001).
Conclusion: Baseline BP and BP progression are strong and independent predictors of incident type 2 diabetes among initially healthy women.
Key Words: Blood pressure • Hypertension • Diabetes mellitus • Metabolic syndrome • Obesity
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