Objectives To analyse the prevalence and risk factors of prehypertension among normal blood pressure diabetic patients. To assess the renal function of prehypertensive diabetic patients. To compare the cumulative incidence of hypertension between prehypertension and ideal blood pressure groups after 5 years followed up and analyse risk factors of it in prehypertensive diabetic patients.
Methods A combination methods of retrospective and prospective analysis was applied to carried out the study. 3 481 type 2 diabetes with normal blood pressure were selected as the research object and devided into the ideal blood pressure and prehypertension groups according to th level of blood pressure. To analyse the prevalence, risk factors and renel damage of prehypertensive diabetic patients. These patients were followed up for five years and the cumulative incidence of hypertension were analyse. Risk factors for hypertension in prehypertensive diabetic patients were evaluated. Excel software was applied for databases and SPSS13.0 software was applied for statistical analysis.
Results Among 3 481 normal blood pressure patients with diabetes, 943 patients (27.1%) belong to the ideal blood pressure group and 2 538 patients (72.9%) belong to prehypertension group. 2 855 cases (82.0%) were male and 626 cases (18.0%) were female. The range of their aged was from 22 to 91 years old and their average age was 57.4 ± 10.6 years old. Results of single factor analysis showed that prevalence of prehypertension in male and female patients was 74.2% vs 67.3%, in snoring and not snoring patients was 74.8% vs 70.0%, in the smoking and nonsmoking patients was 74.4% vs 69.9%. Their difference were significant (P < 0.01). The TG level of ideal blood pressure group and prehypertension group was 1.87 ± 1.51 vs 2.17 ± 1.94 mmol/L. The LDL-C level of two groups was 2.36 ± 0.89 vs 2.64 ± 1.10 mmol/L. The body mass index (BMI) levels was 24.62 ± 3.27 vs 25.53 ± 3.23 Kg/m2. Their difference were significant (P < 0.01). Results of multiariable logistic regression analysis showed that factors including male, snoring, smoking, high levels of TG, LDL-C and BMI were associated with prehypertension. The prevalence of renal insufficiency in prehypertensive and ideal blood pressure diabetic patients was 38.3% vs 33.5% and the difference was significant (P < 0.01). The 5-years cumulative incidence of hypertension in prehypertensiveand ideal blood pressure diabetic patients was 35.8% (885 cases) vs 22.0% (198 cases) and the difference was significant (P < 0.001). The cumulative incidence of hypertension in male and female prehypertensive diabetic patients was 36.7% vs 31.5% and that in overweight and not overweight prehypertensive diabetic patients was 39.4% vs 31.3%. Their difference were significant (P < 0.05).
Conclusions Male, snoring, smoking, high levels of TG, LDL-C and BMI were risk factors of prehypertensive diabetic patients. Prehypertension was a risk factor of renal insufficiency. For diabetic patients. The 5-years cumulative incidence of hypertension in the prehypertensive diabetic patients was more higher than that in ideal blood pressure diabetic patients. Male and overweight were risk factors of 5-years cumulative incidence of hypertension in prehypertensive diabetic patients. We should further strengthen integrated control of risk factors in prehypertensive diabetic patients and improve the prognosis of patients by comprehensive prevention.