Fasting Blood Glucose and 2-h Postprandial Blood Glucose Predict Hypertension: A Report from the REACTION Study

Diabetes Ther. 2021 Apr;12(4):1117-1128. doi: 10.1007/s13300-021-01019-9. Epub 2021 Mar 4.

Abstract

Introduction: Although diabetes is associated with hypertension, whether high blood glucose levels promote hypertension remains controversial. In this study we compared the predictive power of fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), and glycated hemoglobin (HbA1c) for the development of hypertension.

Methods: This study was a substudy of the REACTION study, an ongoing longitudinal cohort study investigating the relationship of prediabetes and type 2 diabetes with the risk of cancer in an urban Northern Chinese population in Beijing. Logistic regression analysis was used to calculate odds ratios (ORs) after adjustment for risk factors for hypertension, including age, sex, body mass index, and triglycerides.

Results: Among the 3437 participants, 497 developed hypertension during the 4-year follow-up. The logistic regression analysis showed that elevated FPG and 2hPG levels (FPG: OR 1.529; 95% confidence interval [CI] 1.348-1.735; 2hPG: OR 1.144; 95% CI 1.100-1.191), but not HbA1c, were independent risk factors for the development of hypertension. In the highest quartile of FPG and 2hPG levels, the multivariable-corrected ORs were 2.115 (95% CI 1.612-2.777) and 2.346 (95% CI 1.787-3.080), respectively, compared with the lowest quartile. The adjusted models showed no significant correlations between quartile HbA1c levels and the development of hypertension.

Conclusion: Higher FPG and 2hPG levels, but not HbA1c levels, are independent risk factors for developing hypertension in an urban Northern Chinese population.

Trial registration: ClinicalTrials.gov NCT01206869.

Keywords: 2-h postprandial glucose; Fasting blood glucose; Glycated hemoglobin; Hypertension; Prediabetes.