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Item #15
Blood
Pressure Rises Decades Before Diabetes Develops
Elevations
in blood pressure precede the development of type 2 diabetes in middle
age by 20 to 25 years.
Higher blood pressure in the pre-diabetic state might contribute to
the presence of vascular disease when the diabetes is diagnosed, say
specialists at Johns Hopkins University School of Medicine, Baltimore,
Maryland.
Although hypertension was known to accompany type 2 diabetes in middle
age, the specialists pointed out that it had not been known how early
in life it began to rise in people who later developed diabetes.
To evaluate elevated blood pressure as a long-term predictor of type 2
diabetes, the specialists assessed systolic and diastolic blood
pressure from young adulthood to middle age in a prospective cohort
study of 1,152 white male medical students in The Johns Hopkins
Precursors Study.
Incident diabetes was identified by self-reporting in mailed
questionnaires verified by medical record reviews.
During a median follow-up of 38 years, 77 cases of incident
diabetes occurred. The mean age of diabetes diagnosis was 58 years.
As early as age 30 years, mean systolic and diastolic blood pressures
were significantly higher in men who developed diabetes during
follow-up than in those who remained non-diabetic.
The rate of increase in systolic and diastolic blood pressures over
time in men who developed diabetes was greater than it was in men who
did not develop diabetes.
After adjustment for body mass index and other risk factors for
diabetes, systolic and diastolic blood pressures at age 30 years
remained significantly higher in men who developed diabetes than in
those who did not. Diabetes
Care 2003;26:4:1110-1115.
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