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Two-hour glucose predicts the development of hypertension over 5 years: the AusDiab study

Journal of Human Hypertension volume 22, pages 168–176 (2008)Cite this article

Abstract

Elevated 2-h plasma glucose concentration (2hPG) from an oral glucose tolerance (OGTT) test more strongly predicts risk of subsequent cardiovascular disease than fasting plasma glucose (FPG), but the association between these glucose measurements and hypertension risk is less clear. We examined the association between 2hPG, FPG and risk of hypertension. We conducted a prospective observational study (The Australian Diabetes, Obesity and Lifestyle Study—AusDiab) among 4413 Australian residents who attended a baseline (1999–2000) and follow-up (2004–2005) examinations. Measurements included blood pressure (mean of two readings), 75 g OGTT, fasting insulin, anthropometrics, dietary and alcohol intake, medical history and physical activity. Hypertension was defined as a systolic blood pressure (SBP)⩾140 or a diastolic blood pressure (DBP)⩾90 mm Hg or treatment with medication for hypertension. HOMA-S was calculated as a measure of insulin sensitivity using the HOMA2 calculator. Hypertension developed in 14% of the 4306 subjects available for this analysis. Higher 2hPG was significantly related to greater risk of hypertension after adjustment for age, gender, FPG, BMI (baseline and difference), waist circumference (baseline and difference), education, exercise, alcohol intake, baseline SBP and smoking (OR (95% CI) 1.12 (1.01 to 1.23)), but no significant association was seen between FPG and hypertension in this model (1.02 (0.88–1.19)). Further adjustment for HOMA-S did not change these findings. Higher baseline 2hPG was more strongly associated with an increase in SBP than in DBP over 5 years. We conclude that higher 2hPG predicted future hypertension occurrence in this population.

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Acknowledgements

The AusDiab study is supported by a National Health and Medical Research Council (NHMRC) project grant (233200). ELMB is supported by an NHMRC (379305)/National Heart Foundation (PP 05M 2346) joint postgraduate scholarship.

We also acknowledge the generous support given by the following: the Australian Government Department of Health and Ageing. Abbott Australasia Pty Ltd, Alphapharm Pty Ltd, AstraZeneca, Bayer HealthCare AG, Bristol-Myers Squibb, City Health Centre-Diabetes Service-Canberra, Department of Health and Community Services—Northern Territory, Department of Health and Human Services—Tasmania, Department of Health—New South Wales, Department of Health—Western Australia, Department of Health—South Australia, Department of Human Services—Victoria, Diabetes Australia, Diabetes Australia Northern Territory, Eli Lilly Australia, Estate of the Late Edward Wilson, GlaxoSmithKline, Jack Brockhoff Foundation, Janssen-Cilag, Kidney Health Australia, Marian & FH Flack Trust, Menzies Research Institute, Merck Sharp & Dohme, Novartis Pharmaceuticals, Novo Nordisk Pharmaceuticals, Pfizer Pty Ltd, Pratt Foundation, Queensland Health, Roche Diagnostics Australia, Royal Prince Alfred Hospital, Sydney, Sanofi Synthelabo and Sanofi Aventis. Also, for their invaluable contribution to the set-up and field activities of AusDiab, we are enormously grateful to A Allman, B Atkins, S Bennett, A Bonney, S Chadban, M de Courten, M Dalton, D Dunstan, T Dwyer, H Jahangir, D Jolley, D McCarty, A Meehan, N Meinig, S Murray, K O'Dea, K Polkinghome, P Phillips, C Reid, A Stewart, R Tapp, H Taylor, T Whalen and F Wilson.

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Authors and Affiliations

  1. International Diabetes Institute, Caulfield, Victoria, Australia

    E J Boyko, E L M Barr, P Z Zimmet & J E Shaw

  2. Department of Medicine, University of Washington, Seattle, WA, USA

    E J Boyko

  3. Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA

    E J Boyko

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  1. E J Boyko
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Boyko, E., Barr, E., Zimmet, P. et al. Two-hour glucose predicts the development of hypertension over 5 years: the AusDiab study. J Hum Hypertens 22, 168–176 (2008). https://doi.org/10.1038/sj.jhh.1002316

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