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Degree of Blood Pressure Control and Incident Diabetes Mellitus in Chinese Adults With Hypertension
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 R...
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Published in: | Journal of the American Heart Association 2020-08, Vol.9 (16), p.e017015-e017015 |
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creator | Zhang, Yuanyuan Nie, Jing Zhang, Yan Li, Jianping Liang, Min Wang, Guobao Tian, Jianwei Liu, Chengzhang Wang, Binyan Cui, Yimin Wang, Xiaobin Huo, Yong Xu, Xiping Hou, Fan Fan Qin, Xianhui |
description | 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 |
doi_str_mv | 10.1161/JAHA.120.017015 |
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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.]]></description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.120.017015</identifier><identifier>PMID: 32755254</identifier><language>eng</language><publisher>England: John Wiley and Sons Inc</publisher><subject>Aged ; Antihypertensive Agents - therapeutic use ; Blood Pressure Determination ; China - epidemiology ; degree of blood pressure control ; Diabetes Mellitus - blood ; Diabetes Mellitus - diagnosis ; Diabetes Mellitus - drug therapy ; Diabetes Mellitus - epidemiology ; Double-Blind Method ; Enalapril - therapeutic use ; Fasting - blood ; Female ; Folic Acid - therapeutic use ; Humans ; hypertension ; Hypertension - drug therapy ; Hypoglycemic Agents - therapeutic use ; Incidence ; incident diabetes mellitus ; Male ; Middle Aged ; Odds Ratio ; Original Research ; Propensity Score ; regression to normal fasting glucose ; Risk ; systolic blood pressure</subject><ispartof>Journal of the American Heart Association, 2020-08, Vol.9 (16), p.e017015-e017015</ispartof><rights>2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-d57371b4645ac100f59e117c752486965b882ef7bda78121ab344e49d0f6cf513</citedby><cites>FETCH-LOGICAL-c459t-d57371b4645ac100f59e117c752486965b882ef7bda78121ab344e49d0f6cf513</cites><orcidid>0000-0001-7812-7982 ; 0000-0003-4451-302X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660809/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660809/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32755254$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Yuanyuan</creatorcontrib><creatorcontrib>Nie, Jing</creatorcontrib><creatorcontrib>Zhang, Yan</creatorcontrib><creatorcontrib>Li, Jianping</creatorcontrib><creatorcontrib>Liang, Min</creatorcontrib><creatorcontrib>Wang, Guobao</creatorcontrib><creatorcontrib>Tian, Jianwei</creatorcontrib><creatorcontrib>Liu, Chengzhang</creatorcontrib><creatorcontrib>Wang, Binyan</creatorcontrib><creatorcontrib>Cui, Yimin</creatorcontrib><creatorcontrib>Wang, Xiaobin</creatorcontrib><creatorcontrib>Huo, Yong</creatorcontrib><creatorcontrib>Xu, Xiping</creatorcontrib><creatorcontrib>Hou, Fan Fan</creatorcontrib><creatorcontrib>Qin, Xianhui</creatorcontrib><title>Degree of Blood Pressure Control and Incident Diabetes Mellitus in Chinese Adults With Hypertension</title><title>Journal of the American Heart Association</title><addtitle>J Am Heart Assoc</addtitle><description><![CDATA[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.]]></description><subject>Aged</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Blood Pressure Determination</subject><subject>China - epidemiology</subject><subject>degree of blood pressure control</subject><subject>Diabetes Mellitus - blood</subject><subject>Diabetes Mellitus - diagnosis</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Double-Blind Method</subject><subject>Enalapril - therapeutic use</subject><subject>Fasting - blood</subject><subject>Female</subject><subject>Folic Acid - therapeutic use</subject><subject>Humans</subject><subject>hypertension</subject><subject>Hypertension - drug therapy</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>incident diabetes mellitus</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Original Research</subject><subject>Propensity Score</subject><subject>regression to normal fasting glucose</subject><subject>Risk</subject><subject>systolic blood pressure</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVkc1PHCEYhydNm2qsZ28Nx152BYbPS5Pt2na3sWkPGo-EgXd2MbOwBcbE_76jq0a5QODH88L7NM0ZwXNCBDn_tVgt5oTiOSYSE_6uOaaYyZnWCr9_tT5qTku5xdMQVLZcf2yOWio5p5wdN-4CNhkApR59G1Ly6G-GUsYMaJlizWlANnq0ji54iBVdBNtBhYJ-wzCEOhYUIlpuQ4QCaOHHoRZ0E-oWre73kCvEElL81Hzo7VDg9Gk-aa5_fL9armaXf36ul4vLmWNc15nnspWkY4Jx6wjGPddAiHSSU6aEFrxTikIvO2-lIpTYrmUMmPa4F67npD1p1geuT_bW7HPY2Xxvkg3mcSPljbG5BjeA0c56jilvQSlGeK86R9TUMa5tLwRxE-vrgbUfux14N30-2-EN9O1JDFuzSXdGCoEV1hPgyxMgp38jlGp2obipazZCGouhrMVa6lawKXp-iLqcSsnQv5Qh2DyYNg-mzWTaHExPNz6_ft1L_tlr-x-a5qNm</recordid><startdate>20200818</startdate><enddate>20200818</enddate><creator>Zhang, Yuanyuan</creator><creator>Nie, Jing</creator><creator>Zhang, Yan</creator><creator>Li, Jianping</creator><creator>Liang, Min</creator><creator>Wang, Guobao</creator><creator>Tian, Jianwei</creator><creator>Liu, Chengzhang</creator><creator>Wang, Binyan</creator><creator>Cui, Yimin</creator><creator>Wang, Xiaobin</creator><creator>Huo, Yong</creator><creator>Xu, Xiping</creator><creator>Hou, Fan Fan</creator><creator>Qin, Xianhui</creator><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-7812-7982</orcidid><orcidid>https://orcid.org/0000-0003-4451-302X</orcidid></search><sort><creationdate>20200818</creationdate><title>Degree of Blood Pressure Control and Incident Diabetes Mellitus in Chinese Adults With Hypertension</title><author>Zhang, Yuanyuan ; Nie, Jing ; Zhang, Yan ; Li, Jianping ; Liang, Min ; Wang, Guobao ; Tian, Jianwei ; Liu, Chengzhang ; Wang, Binyan ; Cui, Yimin ; Wang, Xiaobin ; Huo, Yong ; Xu, Xiping ; Hou, Fan Fan ; Qin, Xianhui</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-d57371b4645ac100f59e117c752486965b882ef7bda78121ab344e49d0f6cf513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Blood Pressure Determination</topic><topic>China - epidemiology</topic><topic>degree of blood pressure control</topic><topic>Diabetes Mellitus - blood</topic><topic>Diabetes Mellitus - diagnosis</topic><topic>Diabetes Mellitus - drug therapy</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Double-Blind Method</topic><topic>Enalapril - therapeutic use</topic><topic>Fasting - blood</topic><topic>Female</topic><topic>Folic Acid - therapeutic use</topic><topic>Humans</topic><topic>hypertension</topic><topic>Hypertension - drug therapy</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Incidence</topic><topic>incident diabetes mellitus</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Original Research</topic><topic>Propensity Score</topic><topic>regression to normal fasting glucose</topic><topic>Risk</topic><topic>systolic blood pressure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Yuanyuan</creatorcontrib><creatorcontrib>Nie, Jing</creatorcontrib><creatorcontrib>Zhang, Yan</creatorcontrib><creatorcontrib>Li, Jianping</creatorcontrib><creatorcontrib>Liang, Min</creatorcontrib><creatorcontrib>Wang, Guobao</creatorcontrib><creatorcontrib>Tian, Jianwei</creatorcontrib><creatorcontrib>Liu, Chengzhang</creatorcontrib><creatorcontrib>Wang, Binyan</creatorcontrib><creatorcontrib>Cui, Yimin</creatorcontrib><creatorcontrib>Wang, Xiaobin</creatorcontrib><creatorcontrib>Huo, Yong</creatorcontrib><creatorcontrib>Xu, Xiping</creatorcontrib><creatorcontrib>Hou, Fan Fan</creatorcontrib><creatorcontrib>Qin, Xianhui</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Yuanyuan</au><au>Nie, Jing</au><au>Zhang, Yan</au><au>Li, Jianping</au><au>Liang, Min</au><au>Wang, Guobao</au><au>Tian, Jianwei</au><au>Liu, Chengzhang</au><au>Wang, Binyan</au><au>Cui, Yimin</au><au>Wang, Xiaobin</au><au>Huo, Yong</au><au>Xu, Xiping</au><au>Hou, Fan Fan</au><au>Qin, Xianhui</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Degree of Blood Pressure Control and Incident Diabetes Mellitus in Chinese Adults With Hypertension</atitle><jtitle>Journal of the American Heart Association</jtitle><addtitle>J Am Heart Assoc</addtitle><date>2020-08-18</date><risdate>2020</risdate><volume>9</volume><issue>16</issue><spage>e017015</spage><epage>e017015</epage><pages>e017015-e017015</pages><issn>2047-9980</issn><eissn>2047-9980</eissn><abstract><![CDATA[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.]]></abstract><cop>England</cop><pub>John Wiley and Sons Inc</pub><pmid>32755254</pmid><doi>10.1161/JAHA.120.017015</doi><orcidid>https://orcid.org/0000-0001-7812-7982</orcidid><orcidid>https://orcid.org/0000-0003-4451-302X</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Aged Antihypertensive Agents - therapeutic use Blood Pressure Determination China - epidemiology degree of blood pressure control Diabetes Mellitus - blood Diabetes Mellitus - diagnosis Diabetes Mellitus - drug therapy Diabetes Mellitus - epidemiology Double-Blind Method Enalapril - therapeutic use Fasting - blood Female Folic Acid - therapeutic use Humans hypertension Hypertension - drug therapy Hypoglycemic Agents - therapeutic use Incidence incident diabetes mellitus Male Middle Aged Odds Ratio Original Research Propensity Score regression to normal fasting glucose Risk systolic blood pressure |
title | Degree of Blood Pressure Control and Incident Diabetes Mellitus in Chinese Adults With Hypertension |
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