Issue 153 Item 15 Blood Pressure Rises 20-25 Years Before Development of Type 2

Increases in blood pressure in young adulthood precede the development of type 2 diabetes in middle age. ” Hypertension is known to accompany type 2 diabetes in middle age, but it is unknown how early in life blood pressure (BP) begins to rise among individuals who later develop diabetes,” Dr. Sherita Hill Golden and colleagues from Johns Hopkins University School of Medicine, Baltimore, Maryland, note. The investigators used data from the Johns Hopkins Precursors Study involving 1152 former white male medical students to study systolic BP (SBP) and diastolic BP (DBP) longitudinally from young adulthood through middle age in men who eventually developed diabetes.

Seventy-seven cases of incident diabetes occurred over a median follow-up of 38 years. The mean age of the subjects at diagnosis was 58 years. “As early as age 30 years, mean SBP and DBP were significantly higher in men who developed diabetes during follow-up than in those who remained nondiabetic (SBP 122 versus 119 mm Hg, p = 0.009; DBP 78 versus 75 mm Hg, p = 0.0005),” Dr. Golden and colleagues report. These differences remained significant after adjusting for BMI and other risk factors for diabetes.

” Higher BP in the prediabetic state might contribute to the presence of vascular disease at the time of diagnosis of type 2 diabetes,” Dr. Golden and colleagues conclude. Whether this can be prevented by treatment of high blood pressure in young adulthood requires further study, they add. Diabetes Care 2003;26:1110-1113.