Hypertension Triples Women’s Risk for Diabetes

Study finds that it does this outside of the normal risk factors for diabetes, such as obesity.

Compared to women with optimal blood pressure, those with high blood pressure are up to three times more likely to develop type 2 diabetes, a U.S. study finds.

Researchers from Brigham and Women’s Hospital, Harvard Medical School and the Harvard School of Public Health, state that “The link between high blood pressure and diabetes risk was independent of factors known to increase the odds of getting diabetes and cardiovascular disease.” 

The team tracked the health of more than 38,000 female health professionals for more than 10 years. At the start of the study, the women (all free of diabetes or cardiovascular disease) were divided into four groups based on their blood pressure: optimal — below 120 mm/Hg systolic, 75 mm/Hg diastolic; normal — 120-129 mm/Hg systolic, 75-84 mm/Hg diastolic; high-normal — 130-139 mm/Hg systolic, 85-89 mm/Hg diastolic; and high blood pressure — at least 140 mm/Hg systolic, 90 mm/Hg diastolic, and/or a self-reported history of hypertension or treatment for the condition.
After 10 years, 9.4 percent of the women in the high blood pressure group had developed type 2 diabetes, compared with 5.7 percent in the high-normal group, 2.9 percent in the normal group, and 1.4 percent in the optimal group.
After adjusting for a number of factors such as age, smoking, alcohol consumption, body mass index, exercise, and family history of diabetes, the researchers concluded that the women with high blood pressure still had a threefold increased risk of diabetes compared to women with optimal blood pressure.

"We found that obesity was also a strong and independent risk factor for the development of type 2 diabetes. However, statistical analyses showed that the relationship between blood pressure and the onset of type 2 diabetes was similar among women who were normal weight, overweight or obese. There was a threefold increased risk from the lowest to the highest BP category within all three weight categories. This analysis showed that the association between blood pressure and diabetes was not explained by weight alone.

However, women with high normal blood pressure had a much higher risk, and the risk for those with established hypertension was substantial. After 10 years, almost 10% of these women had diabetes, according to the researchers.
Although the absolute risk was highest among overweight and obese women, a strong association remained for normal-weight women, they said. Also among women with no more than one of three components of the metabolic syndrome, excluding glucose or blood pressure, the same strong trend across the blood pressure categories remained.
Lead author Dr. David Conen and his colleagues suggested that a possible mechanism for the link between blood pressure and diabetes may be endothelial dysfunction — the disruption of normal biochemical processes carried out by the cells that line the inner surfaces of blood vessels.

"It may be a precursor of both hypertension and diabetes," Conen said. "Thus, the progression of endothelial dysfunction may cause worsening of both BP and blood glucose. This is line with the fact that both BP and blood glucose occur together as part of the metabolic syndrome," a combination of health problems that increase the risk of cardiovascular disease and diabetes.

Practice Pearl:  Explain to interested patients that this study found that maintaining normal blood pressure helps cut the risk of developing type 2 diabetes in women

Conen D, et al "Blood pressure and risk of developing type 2 diabetes mellitus: The Women’s Health Study" European Heart Journal 2007

=============================
DID YOU KNOW:
Many patients don’t realize that blood pressure should be controlled before starting daily aspirin: Aspirin lowers the risk of heart attack and ischemic stroke.  But it increases the risk of hemorrhagic stroke…especially at higher blood pressure.  This is especially a concern in patients taking aspirin to prevent an INITIAL heart attack or stroke.  These patients get less benefit from aspirin than patients who already have heart disease. So a higher risk of bleeding could negate any benefit from taking aspirin.  For people without heart disease, you can prevent one cardiovascular event by treating 300 patients with aspirin for 6 years.  But one out of 350 patients will get a major bleed.  Even worse, some evidence suggests aspirin might not work as well to prevent a first cardiovascular event at higher blood pressures.  Advise patients of the importance of controlling blood pressure if they take daily aspirin. Suggest getting BP under 150/90…and preferably lower to reach their goal.  U.S. Preventive Services Task Force. Aspirin for the primary prevention of cardiovascular events: recommendations and rationale. Ann Intern Med 2002;136:157-60.
=============================

Advertisement
You’ve probably heard the term "low glycemic" bandied about in the media and in discussions about weight loss. You may have even come across some food products labeled as such.

It’s All About Sugar
"Glycemic" simply means "relating to sugar." The higher the glycemic impact of a food the greater and more rapid its effect on your blood sugar when you eat it. High blood sugar can sabotage your weight-management and better health efforts. Eating lower glycemic foods is definitely the way to go.

Atkins Advantage(r) nutrition bars and shakes are low-glycemic impact and substantiated by clinical testing. A controlled carbohydrate, low sugar way of eating provides you with a powerhouse of nutrients to support your health and stabilized blood-sugar levels. Click here for more information