• Chia-Hung Lin, Jung-Nan Wei, Kang-Chih Fan, Chi-Tai Fang, Wan-Chen Wu, Chung-Yi Yang, Mao-Shin Lin, Shyang-Rong Shih, Cyue-Huei Hua, Yenh-Chen Hsein, Jou-Wei Lin, Lee-Ming Chuang, and Hung-Yuan Li.
• Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan.
• J Formos Med Assoc. 2022 Jan 1; 121 (1 Pt 1): 193-201.

Background/PurposeHypertension is a risk factor of incident diabetes. In 2017, the ACC/AHA updated the definition of hypertension to above 130/80 mmHg, while the 2018 ESC/ESH guideline and the JNC7 criteria remained the cutoff of 140/90 mmHg. This study was aimed to investigate how different cutoffs of hypertension affect the association of hypertension to incident diabetes and the progression of insulin resistance.MethodsA total of 1177 subjects without diabetes at baseline were followed for 4.5 years. Diabetes was diagnosed by the results of oral glucose tolerance tests and hemoglobin A1c, or if anti-diabetic agents were used.ResultsHypertension by both criteria was associated with incident diabetes. Change of HOMA2-IR every 5 years (ΔHOMA2-IR/5 yr) was higher in subjects with hypertension than those without (adjusted p = 0.044). Subjects with treated hypertension had the highest risk of diabetes (HR 2.98, p < 0.001) and ΔHOMA2-IR/5 yr, compared with subjects with normal blood pressure. However, the associations of hypertension, HR of incident diabetes and ΔHOMA2-IR/5 yr were attenuated by the 2017 ACC/AHA criteria, as compared with that by the JNC7 and 2018 ESC/ESH criteria.ConclusionHypertension by both criteria is associated with incident diabetes and accelerated progression of insulin resistance, and the associations are attenuated by the 2017 ACC/AHA criteria.Copyright © 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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