Prediabetes with fasting blood sugar ≥ 100 mg/dl linked to high blood pressure risk
Fasting blood sugar in the range of prediabetes is independently and significantly associated with future development of high blood pressure hypertension, pointed out a study published in the Journal of Cardiovascular Diabetology.
Prediabetes is a well-established risk factor for progression to overt diabetes mellitus (DM), which is in turn associated with the development of hypertension (HTN) and vice versa. However, the role of prediabetes and HbA1c in particular as an independent risk factor for the development of hypertension is unclear.
The study aimed to evaluate the association between both Fasting blood sugar and hemoglobin A1c (HbA1c) levels in the prediabetes range and development of HTN among a large cohort of normotensive subjects.
In the study, Normoglycemia was defined as HbA1c < 5.7% and Fasting blood sugar < 100 mg/dl. Prediabetes was defined according to the ADA criteria, i.e., 6.5% > HbA1c ≥ 5.7% or impaired fasting blood sugar(IFG):126 mg/dl > Fasting blood sugar ≥ 100 mg/dl.
The authors investigated 5016 normotensive participants without DM and other cardiovascular risk factors who were annually screened in a tertiary medical centre. Subjects were divided into normoglycemic and prediabetic groups. Subgroup analysis was made by dividing participants into four groups according to FPG and HbA1C levels, i.e., normoglycemia, impaired HbA1c only, IFG only, and both parameters impaired.
The authors found that 318 subjects developed HTN. A cumulative hazard function for the development of hypertension showed a 2.89-fold increased risk for HTN in the prediabetic population. In a multivariable Cox proportional hazard regression model adjusted to common confounding risk factors for HTN, prediabetes was found to be independently associated with a 1.95-fold increased risk for hypertension. Impaired HbA1C only was not found to be independently associated with HTN, while IFG only showed a 2.13-fold increased risk for HTN compared to normoglycemic, and a 2.55-fold increased risk for HTN when both parameters impaired.
The study demonstrated that Fasting blood sugar in the prediabetes range, albeit not glycated hemoglobin, is independently and significantly associated with future development of high blood pressure. The authors feel that their findings further highlight the pivotal predictive role of Fasting blood sugar for HTN development as opposed to the limited independent role of abnormal HbA1c levels.
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