Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Three-year change in glycemic state and the future risk of incident hypertension among Iranian adults: Tehran Lipid and Glucose Study

Journal of Human Hypertension volume 37, pages 944–949 (2023)Cite this article

Subjects

Abstract

The impact of 3-year change in glycemic state on the risk of hypertension among Tehranian adults aged ≥20 years was assessed. The study population included 1679 men and 2348 women who were non-diabetic normotensive at enrollment. The following categories were defined both at baseline visit and three years later (second visit): normoglycemia [normal fasting glucose (NFG) and normal glucose tolerance (NGT)] and prediabetes [impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)]. Changes in the categories, i.e., regression to normoglycemia, remaining in previous status, and progression to diabetes were assessed. Changes in fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG) categories were also considered separately. We used the Cox models adjusted for traditional hypertension risk factors to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). During a median follow-up of 9.4 years, 485 men and 589 women developed hypertension. Among men, considering both FPG and 2hPG, compared to individuals remaining normoglycemic, changing from prediabetes to normoglycemia had a HR of 1.30 (95% CI: 0.98–1.71; P-value: 0.064). Defining changes by 2hPG showed that compared to remaining NGT, incident IGT (progression from NGT to IGT) had a significant association with increased risk of hypertension development by a HR of 1.61 (1.13–2.30). Among women, on the other hand, change in glycemic state generally didn’t show a significant association with incident hypertension. To sum up, change in glycemic state hadn’t a significant association with hypertension development among women; however, compared to remaining NGT, men with incident IGT had a significant higher risk.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Organization WH. Global status report on noncommunicable diseases 2014. World Health Organization; 2014.

    Google Scholar 

  2. Ogurtsova K, da Rocha Fernandes J, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40–50.

    Article  CAS  PubMed  Google Scholar 

  3. Schlesinger S, Neuenschwander M, Barbaresko J, Lang A, Maalmi H, Rathmann W, et al. Prediabetes and risk of mortality, diabetes-related complications and comorbidities: umbrella review of meta-analyses of prospective studies. Diabetologia. 2021:1–11.

  4. Parizadeh D, Rahimian N, Akbarpour S, Azizi F, Hadaegh F. Sex-specific clinical outcomes of impaired glucose status: a long follow-up from the Tehran Lipid and Glucose Study. Eur J Preventive Cardiol. 2019;26:1080–91.

    Article  Google Scholar 

  5. Association AD. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2020. Diabetes Care. 2020;43:S14–31.

    Article  Google Scholar 

  6. Nandhini LP, Kamalanathan S, Sahoo J. Definition, diagnostic criteria, screening, diagnosis, and classification of diabetes and categories of glucose intolerance. In: The Diabetes Textbook. Springer, 2019, pp 71–85.

  7. Esteghamati A, Etemad K, Koohpayehzadeh J, Abbasi M, Meysamie A, Noshad S, et al. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005–2011. Diabetes Res Clin Pr. 2014;103:319–27.

    Article  Google Scholar 

  8. Moazzeni SS, Ghafelehbashi H, Hasheminia M, Parizadeh D, Ghanbarian A, Azizi F, et al. Sex-specific prevalence of coronary heart disease among Tehranian adult population across different glycemic status: Tehran lipid and glucose study, 2008–2011. BMC Public Health. 2020;20:1510.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Organization WH. A global brief on hypertension: silent killer, global public health crisis: World Health Day 2013. World Health Organization, 2013.

  10. Mohammadian Khonsari N, Shahrestanaki E, Ejtahed HS, Djalalinia S, Sheidaei A, Hakak-Zargar B, et al. Long-term trends in hypertension prevalence, awareness, treatment, and control rate in the Middle East and North Africa: a systematic review and meta-analysis of 178 population-based studies. Curr Hypertens Rep. 2021;23:41.

    Article  PubMed  Google Scholar 

  11. Asgari S, Moazzeni SS, Azizi F, Abdi H, Khalili D, Hakemi MS, et al. Sex-specific incidence rates and risk factors for hypertension during 13 years of follow-up: the tehran lipid and glucose study. Glob Heart. 2020;15:29–29.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ferrannini E, Cushman WC. Diabetes and hypertension: the bad companions. Lancet. 2012;380:601–10.

    Article  PubMed  Google Scholar 

  13. De Boer IH, Bangalore S, Benetos A, Davis AM, Michos ED, Muntner P, et al. Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes Care. 2017;40:1273–84.

    Article  PubMed  Google Scholar 

  14. Bjørnholt JV, Erikssen G, Kjeldsen SE, Bodegård J, Thaulow E, Erikssen J. Fasting blood glucose is independently associated with resting and exercise blood pressures and development of elevated blood pressure. J Hypertension. 2003;21:1383–9.

    Article  Google Scholar 

  15. Cheung BM, Wat NM, Tso AW, Tam S, Thomas GN, Leung GM, et al. Association between raised blood pressure and dysglycemia in Hong Kong Chinese. Diabetes Care. 2008;31:1889–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Geva M, Shlomai G, Berkovich A, Maor E, Leibowitz A, Tenenbaum A, et al. The association between fasting plasma glucose and glycated hemoglobin in the prediabetes range and future development of hypertension. Cardiovasc Diabetol. 2019;18:53.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kuwabara M, Chintaluru Y, Kanbay M, Niwa K, Hisatome I, Andres-Hernando A, et al. Fasting blood glucose is predictive of hypertension in a general Japanese population. J Hypertension. 2019;37:167–74.

    Article  CAS  Google Scholar 

  18. Jung JY, Oh C-M, Choi J-M, Ryoo J-H, Park SK. Long-term risk of hypertension in normoglycemia and prediabetes, and their relation to the change of glycemic state. Am J Hypertension. 2018;31:1042–8.

    Article  CAS  Google Scholar 

  19. Britton KA, Pradhan AD, Gaziano JM, Manson JE, Ridker PM, Buring JE, et al. Hemoglobin A1c, body mass index, and the risk of hypertension in women. Am J Hypertension. 2011;24:328–34.

    Article  CAS  Google Scholar 

  20. Mohan V, Anjana RM, Unnikrishnan R, Venkatesan U, Sankari GU, Rahulashankiruthiyayan T, et al. Incidence of hypertension among Asian Indians: 10 year follow up of the Chennai Urban Rural Epidemiology Study (CURES-153). J Diabetes Complications. 2020;34:107652.

    Article  PubMed  Google Scholar 

  21. Kabootari M, Hasheminia M, Azizi F, Mirbolouk M, Hadaegh F. Change in glucose intolerance status and risk of incident cardiovascular disease: Tehran Lipid and Glucose Study. Cardiovascular Diabetol. 2020;19:1–11.

    Article  Google Scholar 

  22. Lee G, Kim SM, Choi S, Kim K, Jeong S-M, Son JS, et al. The effect of change in fasting glucose on the risk of myocardial infarction, stroke, and all-cause mortality: a nationwide cohort study. Cardiovascular Diabetol. 2018;17:1–10.

    Article  Google Scholar 

  23. Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, et al. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials. 2009;10:1–15.

    Article  Google Scholar 

  24. Momenan AA, Delshad M, Sarbazi N, Rezaei Ghaleh N, Ghanbarian A, Azizi F. Reliability and validity of the Modifiable Activity Questionnaire (MAQ) in an Iranian urban adult population. Arch Iran Med. 2012;15:279–82.

    PubMed  Google Scholar 

  25. Diagnosis ECot. Mellitus* CoD. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care. 2003;26:3160–7.

    Article  Google Scholar 

  26. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr., et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–71.

    Article  CAS  PubMed  Google Scholar 

  27. Cordero A, Alegria-Ezquerra E. TG/HDL ratio as surrogate marker for insulin resistance. EJ Cardiol Pr [Internet]. 2009;8:16.

    Google Scholar 

  28. Derakhshan A, Tohidi M, Hajebrahimi M, Saadat N, Azizi F, Hadaegh F. Sex‐specific incidence rates and risk factors of insulin resistance and β–cell dysfunction: a decade follow‐up in a Middle Eastern population. Diabet Med. 2017;34:245–52.

    Article  CAS  PubMed  Google Scholar 

  29. Perreault L. Prediabetes. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, et al. (eds). Endotext. South Dartmouth (MA): MDText.com, Inc. Copyright © 2000-2022; 2000.

    Google Scholar 

  30. Tramunt B, Smati S, Grandgeorge N, Lenfant F, Arnal JF, Montagner A, et al. Sex differences in metabolic regulation and diabetes susceptibility. Diabetologia. 2020;63:453–61.

    Article  PubMed  Google Scholar 

  31. Goossens GH, Jocken JW, Blaak EE. Sexual dimorphism in cardiometabolic health: the role of adipose tissue, muscle and liver. Nat Rev Endocrinol. 2021;17:47–66.

    Article  PubMed  Google Scholar 

  32. Sullivan GM, Feinn R. Using effect size-or why the P value is not enough. J Grad Med Educ. 2012;4:279–82.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors would like to express their appreciation to the TLGS participants and staff for their kind cooperation.

Author information

Authors and Affiliations

  1. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Seyyed Saeed Moazzeni, Soheil Dehghani, Mitra Hasheminia, Reyhane Hizomi Arani & Farzad Hadaegh

  2. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Fereidoun Azizi

Authors
  1. Seyyed Saeed Moazzeni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Soheil Dehghani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mitra Hasheminia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Reyhane Hizomi Arani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fereidoun Azizi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Farzad Hadaegh
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study conception and design: SSM and FH. Analysis and interpretation of data: MH and FH. Drafting of the manuscript: SSM, SD and FH. Critical revision: RHA, FA and FH. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Farzad Hadaegh.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval

The ethics committee of the Research Institute for Endocrine Sciences of the Shahid Beheshti University of Medical Sciences approved the study proposal (IR.SBMU.ENDOCRINE.REC.1400.138).

Informed consent

Written informed consent was also obtained from all participants.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moazzeni, S.S., Dehghani, S., Hasheminia, M. et al. Three-year change in glycemic state and the future risk of incident hypertension among Iranian adults: Tehran Lipid and Glucose Study. J Hum Hypertens 37, 944–949 (2023). https://doi.org/10.1038/s41371-022-00788-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41371-022-00788-5

Search

Advanced search

Quick links