HIGH BLOOD-PRESSURE AND THE INCIDENCE OF NON-INSULIN-DEPENDENT DIABETES-MELLITUS - FINDINGS IN A 11.5 YEAR FOLLOW-UP-STUDY IN THE NETHERLANDS

被引:34
作者
STOLK, RP
VANSPLUNDER, IP
SCHOUTEN, JSAG
WITTEMAN, JCM
HOFMAN, A
GROBBEE, DE
机构
[1] Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, 3000 DR
关键词
BLOOD PRESSURE; DIURETICS; HEART RATE; OBESITY; RISK FACTORS; FOLLOW-UP;
D O I
10.1007/BF00158782
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
To examine the contribution of cardiovascular risk factors to the development of non-insulin dependent diabetes mellitus, a prospective follow-up study was performed of a cohort, initially examined in a population survey on cardiovascular risk factors. The survey was conducted from 1975 to 1978 in the Netherlands among 5700 men and women aged 20 to 65. In 1988 a questionnaire on the prevalence of chronic diseases, including diabetes mellitus, was sent to all living participants of the initial survey. The general practitioners of the persons who indicated to have diabetes mellitus were asked to confirm the diagnosis. Diabetes mellitus was defined as current use of oral hypoglycemic drugs or insulin. After exclusion of the prevalent cases at the initial survey, 65 incident confirmed cases remained. All others responding to the questionnaire served as controls. The incidence of diabetes mellitus was associated with body mass index, use of diuretics, systolic and diastolic blood pressure. After adjustment for age and body mass index systolic and diastolic blood pressure were still associated with the incidence of non-insulin dependent diabetes mellitus in men; relative risks 1.28 (95% confidence interval 1.06-1.54) and 1.40 (95% CI 1.06-1.85) per 10 mmHg respectively. For women, only the relative risk associated with the use of diuretics remained statistically significant (2.26, 95% CI 1.04-4.90). This probably reflects the risk of (treated) hypertension: adjusted for blood pressure, the relative risk lost statistical significance. These findings suggest that elevated blood pressure is a risk for the development of non-insulin dependent diabetes mellitus (NIDDM). This supports the view that NIDDM and hypertension may have a similar origin.
引用
收藏
页码:134 / 139
页数:6
相关论文
共 20 条
[1]  
Barrett-Connor E., Epidemiology, obesity, and non-insulin-dependent diabetes mellitus, Epidemiol. Rev., 11, pp. 172-181, (1989)
[2]  
Butler W.J., Ostrander L.D., Carman W.J., Lamphiear D.E., Diabetes mellitus in Tecumseh, Michigan. Prevalence, incidence, and associated conditions, Am. J. Epidemiol., 116, pp. 971-980, (1982)
[3]  
Copeland K.T., Checkoway H., McMichael A.J., Holbrook R.H., Bias due to misclassification in the estimation of relative risk, Am. J. Epidemiol., 105, pp. 488-495, (1977)
[4]  
De Fronzo R.A., Ferranini E., Insuline resistance: a multifaced syndrome responsible for NIDDM, hypertension dyslipidemia, and atherosclerotic cardiovascular disease, Diabetes Care, 14, pp. 173-194, (1991)
[5]  
Ferrari P., Weidman P., Insulin, insulin sensitivity and hypertension, J. Hypertension, 8, pp. 491-500, (1990)
[6]  
Feskens E.J.M., Kromhout D., Cardiovascular risk factors and the 25-year incidence of diabetes mellitus in middle-aged men. The Zutphen Study, Am. J. Epidemiol., 130, pp. 1101-1108, (1989)
[7]  
Feskens E.J.M., Kromhout D., Effects of body fat and its development over a ten-year period on glucose tolerance in euglycaemic men: The Zutphen Study, Int. J. Epidemiol., 18, pp. 368-373, (1989)
[8]  
Grobbee D.E., Rimm E.B., Giovannucci E., Colditz G., Stampfer M., Willett W., Coffee, caffeine, and cardiovascular disease in men, N. Eng. J. Med., 323, pp. 1026-1032, (1990)
[9]  
Haffner S.M., Stern M.P., Hazuda H.P., Mitchell B.D., Patterson J.K., Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start thicking before the onset of clinical diabetes?, JAMA, 263, pp. 2893-2898, (1990)
[10]  
Harris M.I., Hadden W.C., Knowler W.C., Bennett P.H., Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in U.S. population aged 20–74 years, Diabetes, 36, pp. 523-534, (1987)