Is pulse pressure a predictor of new-onset diabetes in high-risk hypertensive patients?: a subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial.

• 保野, 慎治

• Ueshima, Kenji

• Oba, Koji

• Fujimoto, Akira

• Hirata, Masakazu

• Ogihara, Toshio

• Saruta, Takao

• Nakao, Kazuwa

抄録

OBJECTIVE: Hypertensive patients have an increased risk of developing diabetes. Accumulating evidence suggests a close relation between metabolic disturbance and increased arterial stiffness. Here, we examined the association between pulse pressure and the risk of new-onset diabetes in high-risk Japanese hypertensive patients. RESEARCH DESIGN AND METHODS: The Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial examined the effects of candesartan and amlodipine on the incidence of cardiovascular events in 4, 728 high-risk Japanese hypertensive patients. In the present study, we analyzed the relationship between pulse pressure at baseline and new-onset diabetes in 2, 685 patients without diabetes at baseline (male 1, 471; mean age 63.7 years; mean BMI 24.8 kg/m(2)) as a subanalysis of the CASE-J trial. RESULTS: During 3.3 +/- 0.8 years of follow-up, 97 patients (3.6%) developed diabetes. In multiple Cox regression analysis, pulse pressure was an independent predictor for new-onset diabetes (hazard ratio [HR] per 1 SD increase 1.44 [95% CI 1.15-1.79]) as were male sex, BMI, and additional use of diuretics, whereas age and heart rate were not. Plots of HRs for new-onset diabetes considering both systolic and diastolic blood pressure (DBP) revealed that a higher pulse pressure with a lower DBP, indicating that the increased pulse pressure was largely due to increased arterial stiffness, was strongly associated with the risk of new-onset diabetes. CONCLUSIONS: Pulse pressure is an independent predictor of new-onset diabetes in high-risk Japanese hypertensive patients. Increased arterial stiffness may be involved in the development of diabetes.

収録刊行物

• Diabetes care

  Diabetes care 33 (5), 1122-1127, 2010-05

  American Diabetes Association

キーワード

• Age of Onset
• Aged
• Antihypertensive Agents/therapeutic use
• Asian Continental Ancestry Group/statistics & numerical data
• Benzimidazoles/therapeutic use
• Blood Pressure
• Body Mass Index
• Diabetes Mellitus, Type 2/diagnosis
• Diabetes Mellitus, Type 2/mortality
• Female
• Follow-Up Studies
• Humans
• Hypertension/diagnosis
• Hypertension/drug therapy
• Hypertension/mortality
• Male
• Middle Aged
• Multicenter Studies as Topic
• Outcome Assessment (Health Care)
• Predictive Value of Tests
• Proportional Hazards Models
• Randomized Controlled Trials as Topic
• Risk Factors
• Tetrazoles/therapeutic use

詳細情報

• CRID: 1050282677154613888
• NII論文ID: 120002484962
• NII書誌ID: AA00160920
• ISSN: 01495992
• HANDLE: 2433/126739
• 本文言語コード: en
• 資料種別: journal article
• データソース種別:
  • IRDB
  • CiNii Articles