Diabetes and obesity are significant risk factors for morning hypertension: From Ibaraki Hypertension Assessment Trial (I-HAT)

Toyama, Masahiro; Watanabe, Shigeyuki; Miyauchi, Takashi; Kuroda, Yasuhiro; Ojima, Eiji; Sato, Akira; Seo, Yoshihiro; Aonuma, Kazutaka

doi:10.1016/j.lfs.2014.03.029

Cited by 11 publications

(5 citation statements)

References 33 publications

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“…We also notice that diabetes frequently precedes coronary heart disease, 33 chronic kidney disease 34 and hypertension, 35 which are major risk factors and account for the majority of HF cases, 5 further explaining the close relationship between DM and HF observed in epidemiological studies.…”

mentioning

confidence: 64%

Diabetes Mellitus and Heart Failure

Tousoulis

Oikonomou

Siasos

et al. 2014

European Cardiology Review

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Diabetes mellitus and heart failure are two multifaceted entities characterised by high morbidity and mortality. Early epidemiological and prospective studies have observed the frequent co-existence of both conditions. Importantly, diabetes mellitus can precipitate or worsen heart failure due to the accumulation of advanced glycation end products, oxidative stress, inflammatory status impairment, decay of intracellular calcium, changes in microRNAs expression, not to mention atherosclerosis progression and coronary artery disease. Heart failure also impairs glucose metabolism through less well-known mechanisms. Attention must especially be given in the treatment as there are frequently adverse interactions between the two diseases and novel agents against diabetic cardiomyopathy are under investigation. As several missing links still exist in the connection between heart failure and diabetes mellitus we will review, in this article, the most recent data underlying the interaction of them and provide an overview of the most important clinical perspectives.

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mentioning

confidence: 64%

Diabetes Mellitus and Heart Failure

Tousoulis

Oikonomou

Siasos

et al. 2014

European Cardiology Review

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“…26 In contrast, observational evidence revealed that diabetic or obese patients frequently have morning hypertension. 27 A case-control study demonstrated that diabetes was a significant risk factor for hypertension and that diabetes positively interacted with hypertension. 28 Therefore, we hypothesized that hypertension and diabetes are causally linked.…”

Section: Causal Relationships Between Chronic Diseases Hypertension A...mentioning

confidence: 99%

Causal Paradigm Between Common Comorbidities of Cardiovascular and Metabolism-Related Diseases in Elderly: Evidence from Cross-Sectional and Mendelian Randomization Studies

Gu,

Wang,

et al. 2023

DMSO

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Background Comorbidity is a common problem among elderly people, significantly damaging individuals’ health and healthcare systems. However, observational studies may be susceptible to residual confounding factors and bias. The present study aimed to assess the causal effect of common chronic disease comorbidity using the Mendelian randomization (MR) approach. Methods Data for the present study were obtained from a community survey conducted between 2018 and 2020 in four counties in Ganzhou City, southern China. A cross-sectional survey was conducted using a multi-stage stratified random sampling method. A total of 1756 valid questionnaires were collected to analyze common chronic disease comorbidities. Genetic variants associated with hypertension, diabetes, stroke, and hyperlipidemia-related factors were selected as instrumental variables for univariate and multivariate MR analyses. Results The self-reported prevalence of chronic disease in the older adult population in Southern China was 68.1%, with hypertension (46.1%), diabetes (10.5%), and hyperlipidemia (8.5%) being the three most common conditions. The prevalence of chronic disease comorbidity was 20.7% among the 12 chronic diseases studied. Hypertension was identified as a predictor of diabetes ( OR [95% CI] : 1.114 [1.049, 1.184], p < 0.001), and diabetes mellitus was equally identified as a risk factor for hypertension ( OR [95% CI] : 1.118 [1.069, 1.187], p < 0.001). Furthermore, high triglyceride levels were identified as a risk factor for hypertension ( OR [95% CI] : 1.262 [1.129, 1.411], p < 0.001). In contrast to intracranial hemorrhages, hypertension had a significant impact on ischemic stroke ( OR [95% CI] : 1.299 [1.161, 1.454], p < 0.001). Conclusion The causal association between multiple cardiovascular and metabolism-related diseases is mediated by hypertension, with a bidirectional cause-and-effect relationship between hypertension and diabetes. Hypertension is a risk factor for ischemic stroke, and the hyperlipidemia-related factor triglycerides (TG) influence hypertension. Therefore, prioritizing hypertension prevention and control in the elderly is critical for effective chronic disease management.

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“…The Ibaraki Hypertension Assessment Trial (I-HAT) examined the home BP of 2,554 hypertensive patients including type 2 diabetes patients (20%) who were undergoing hypotensive therapy and found that as glucose tolerance gradually worsened, from normal, abnormal, and ultimately to diabetes, the subjects' early morning home BP became significantly higher, from 134.1 and 135.4 mmHg to 137.5 mmHg. Their frequency of morning hypertension ( > 135/ 85 mmHg) also rose significantly, from 53.4 and 55.6 to 66.4% [55]. Furthermore, despite undergoing treatment for hypertension,~60% of diabetic patients still manifested morning hypertension and eventually developed microangiopathy and cerebrovascular disorders.…”

Section: Abnormal Circadian Blood Pressure Variations In Diabetic Patmentioning

confidence: 99%

Clinical features and therapeutic perspectives on hypertension in diabetics

2018

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Over 50% of patients with diabetes mellitus, either type 1 or 2, ultimately develop hypertension as a complication. In diabetics, this further increases the incidence of cardiovascular disease (CVD) by 2-to 3-fold and accelerates the progression of diabetic nephropathy. Arteriosclerosis, a clinical feature of hypertension in diabetics, develops and advances from a young age. Therefore, in providing treatment, it is necessary to evaluate the degree of arteriosclerosis. Diabetic patients are encouraged to strictly control their blood glucose levels. Recently developed drugs, such as GLP-1 receptor agonists, DPP-4 inhibitors and SGLT2 inhibitors, also have hypotensive actions, making them ideal for use in diabetics with hypertension. SGLT2 inhibitors and GLP-1 receptor agonists reportedly suppress the onset and progression of CVD, as well as diabetic nephropathy. The possibility of hypoglycemia triggering blood pressure elevation and arrhythmia has been noted, so a key point here is not to cause hypoglycemia. In selecting hypotensive agents, we must choose types that do not aggravate insulin resistance and engage in hypotensive treatment that also considers both nocturnal and morning hypertension. In addition, facing the onset of an aging society, there is a growing need for treatments that do not cause excessive blood pressure reduction or hypoglycemia. Favorable lifelong blood pressure and glucose control are increasingly important for the treatment of diabetes accompanied by hypertension.

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Diabetes and obesity are significant risk factors for morning hypertension: From Ibaraki Hypertension Assessment Trial (I-HAT)

Abstract: Diabetic or obese patients frequently have morning HT.

Cited by 11 publications

References 33 publications

Diabetes Mellitus and Heart Failure

Diabetes Mellitus and Heart Failure

Causal Paradigm Between Common Comorbidities of Cardiovascular and Metabolism-Related Diseases in Elderly: Evidence from Cross-Sectional and Mendelian Randomization Studies

Clinical features and therapeutic perspectives on hypertension in diabetics

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