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Original Article
Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study
Ahmad Khosravi, Mohammad Hassan Emamian, Hassan Hashemi, Akbar Fotouhi
Epidemiol Health. 2018;40:e2018026.   Published online June 23, 2018
DOI: https://doi.org/10.4178/epih.e2018026
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  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.
METHODS
In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.
RESULTS
The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.
CONCLUSIONS
Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Summary

Citations

Citations to this article as recorded by  
  • Prevalence of prediabetes, diabetes, diabetes awareness, treatment, and its socioeconomic inequality in west of Iran
    Farhad Moradpour, Satar Rezaei, Bakhtiar Piroozi, Ghobad Moradi, Yousef Moradi, Negar Piri, Azad Shokri
    Scientific Reports.2022;[Epub]     CrossRef
  • Association between cardiovascular risk factors and stage 1 hypertension defined by the 2017 ACC/AHA guidelines
    Xing Zhen Liu, Dong Shui Chen, Fu Ping Di, Cheng Yong Shi, Hui Hua Li, Jun Min Wang, Yi Xin Ji
    Clinical and Experimental Hypertension.2020; 42(6): 483.     CrossRef
  • Obesity is the most important factor for gender inequality in type 2 diabetes incidence in an Iranian population
    Ahamd Khosravi, MohammadHassan Hashemian, Hassan Hashemi, Akbar Fotouhi
    International Journal of Preventive Medicine.2019; 10(1): 215.     CrossRef
  • Blood Pressure and the Risk of Death From Non-cardiovascular Diseases: A Population-based Cohort Study of Korean Adults
    Jeoungbin Choi, Jieun Jang, Yoonsuk An, Sue K. Park
    Journal of Preventive Medicine and Public Health.2018; 51(6): 298.     CrossRef
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