Association of Central Aortic Pressures Indexes With Development of Diabetes Mellitus in Essential Hypertension

BACKGROUND Diabetes mellitus (DM) and hypertension (HT) frequently coexist. Increased central aortic pressures indexes are associated with HT; however, possible associations of these indexes with future development of DM have never been studied in HT. METHODS We recruited 178 patients with uncomplicated nondiabetic HT in this study. Baseline glucose, insulin, lipid profiles, and central aortic pressure indexes obtained using applanation tonometry were measured at the beginning of the study. Patients were followed for new-onset DM. RESULTS After a mean follow-up period of 31 +/- 12 months, 22 patients (12.4%) developed new-onset DM. In multivariate regression analyses adjusted for age, sex, and mean blood pressure (BP) in model 1, we found that central systolic BP (CSBP; hazard ratio 1.24, 95% CI1.10-1.41, P < 0.001), and augmentation index (AIx) corrected at heart rate 75/min (AIx(75); hazard ratio 1.58, 95% CI 1.11-1.58, P < 0.05) were independent predictors for new-onset DM. After adjustment for age, sex, mean BP, glucose concentration, and beta-blocker use in model 2, we found that CSBP (hazard ratio 1.36, 95% CI 1.19-1.55, P < 0.001) and AIx(75) (hazard ratio 1.71, 95% CI 1.16-2.52, P < 0.01) were independent predictors for new-onset DM. CONCLUSIONS CSBP and AIx(75) were independent factors for future DM in essential hypertensive patients. Increased central pressure indexes were associated with risk of DM in essential hypertension.