11646

AbstractObjective Hypertensive patients are at 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 (PP) and the risk of new-onset diabetes in high-risk Japanese hypertensive patients. Research Design and Methods The 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 PP 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, PP was an independent predictor for new-onset diabetes (hazard ratio per 1 SD increase 1.44, 95% CI 1.15-1.79), as were male sex, body mass index and additional use of diuretics, whereas age and heart rate were not. Plots of hazard ratios for new-onset diabetes considering both systolic and diastolic blood pressure (DBP) revealed that a higher PP with a lower DBP, indicating that the increased PP was largely due to increased arterial stiffness, was strongly associated with the risk of new-onset diabetes. Conclusion PP 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.
PMID: 20185746 [PubMed - as supplied by publisher]