Hypertension Makes Women Three Times as Likely to Get Diabetes

By Frances Schwartzkopff

Oct. 10 (Bloomberg) -- Women with high blood pressure are three times
as likely to develop diabetes as those with normal blood pressure,
researchers said.

Women whose blood pressure worsens over time also are at greater risk
of the disease, according to the study published today in the European
Heart Journal. Diabetics can't properly process sugar, which collects
in their blood and leads to organ failure and death.

More vigilance is needed to prevent diabetes and heart disease in
women, the study's authors said. Diabetes is a progressive illness,
though its worsening can be slowed though early treatment, including
exercise, diet and medication. Almost 4 million people will die from
diabetes and its complications in 2007, the Brussels-based
International Diabetes Federation estimated.

``Women with increasing blood pressure levels should have their blood
glucose levels monitored,'' said David Conen, the study's lead author
and a research fellow at Harvard Medical School in Boston. Staying
slender didn't help women with high blood pressure avoid the onset of
diabetes, he said.

When the research began in 1993, none of the 38,172 women enrolled had
diabetes or heart disease. Participants were divided into four levels
of blood pressure, the force with which blood pushes against artery
walls when the heart is beating and when it's at rest. The lowest
blood pressure level was 120 over 75, while hypertension was defined
as 140 or higher over 90.

Malfunctioning Cells

After 10 years, 9.4 percent of the women with hypertension had
developed diabetes while only 1.4 percent of those with the lowest
blood pressure had, the researchers found. About 3 percent of those
with normal blood pressure and 5.7 percent of those with moderately
high blood pressure developed the disease.

Malfunctioning of the cells that line the inner surfaces of blood
vessels may be the cause of both diseases, suggesting ``none of the
cardiovascular risk factors should be looked at individually,'' Conen
said. ``The combination of all risk factors should be used to make
treatment decisions.''

To contact the reporter on this story: Frances Schwartzkopff in
Copenhagen at fschwartzkop@bloomberg.net

*  *  *

European Heart Journal Advance Access published online on October 9,
2007

Blood pressure and risk of developing type 2 diabetes mellitus: The
Women's Health Study

David Conen1,*, Paul M Ridker1,2,3, Samia Mora1,2, Julie E.
Buring1,3,4,5 and Robert J. Glynn1,3

1 Division of Preventive Medicine, Department of Medicine, Brigham and
Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue
East, Boston, MA 02215, USA
2 Division of Cardiovascular Medicine, Department of Medicine, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, USA
3 Department of Epidemiology, Harvard School of Public Health, Boston,
MA, USA
4 Division of Aging, Department of Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, USA
5 Department of Ambulatory Care and Prevention, Harvard Medical
School, Boston, MA, USA

* Corresponding author. Tel: +1 617 525 6856; fax: +1 617 734 1437. E-
mail address: conend@uhbs.ch

Aims: To examine the relationship of blood pressure (BP) and BP
progression with the subsequent development of type 2 diabetes.

Methods and results: We performed a prospective cohort study among 38
172 women free of diabetes and cardiovascular disease at baseline.
Women were classified into four categories according to self-reported
baseline BP (<120/75 mmHg, 120-129/75-84 mmHg, 130-139/85-89 mmHg and
hypertension) and were further classified according to progression to
a higher BP category during the first 48 months of follow-up. The main
outcome measure was time to incident type 2 diabetes. During 10.2
years of follow-up, 1672 women developed type 2 diabetes. The
multivariable adjusted hazard ratios (HRs) (95% confidence interval)
for incident diabetes across BP categories were 0.66 (0.55-0.80), 1.0
(referent), 1.45 (1.23-1.71), and 2.03 (1.77-2.32) (P-value for trend
<0.0001). Stratification by body mass index revealed similar results.
Adjusted HRs (95% confidence intervals) for incident diabetes after 48
months among women who had no BP progression, women with BP
progression but remaining normotensive, and women who developed
hypertension during the first 48 months were 1.0, 1.26 (0.97-1.64),
and 1.64 (1.33-2.02) compared with 2.39 (1.95-2.93) in women with
baseline hypertension (P-value for trend <0.0001).

Conclusion: Baseline BP and BP progression are strong and independent
predictors of incident type 2 diabetes among initially healthy women.