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Glycated hemoglobin and risk of hypertension in the atherosclerosis risk in communities study

Julie K Bower1, Lawrence J Appel, Kunihiro Matsushita

  • 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. jbower@jhsph.edu

Diabetes Care
|March 21, 2012
PubMed

Insights

Elevated glycated hemoglobin (HbA1c), even without diabetes, predicts future hypertension. This finding suggests HbA1c may partially explain the link between high blood sugar and cardiovascular disease risk.

Area of Science:

  • Cardiovascular Disease Epidemiology
  • Metabolic Syndrome Research

Background:

  • Diabetes and hypertension frequently co-occur, sharing common risk factors.
  • Hypertension is a known predictor of diabetes, but the reverse association requires further investigation.
  • Hyperglycemia may independently contribute to the development of hypertension.

Purpose of the Study:

  • To investigate the association between glycated hemoglobin (HbA1c) levels and the incidence of hypertension.
  • To determine if HbA1c predicts future hypertension in individuals without diagnosed diabetes.

Main Methods:

  • Prospective analysis of 9,603 middle-aged participants from the Atherosclerosis Risk in Communities Study.
  • Cox proportional hazards models used to assess the relationship between baseline HbA1c and incident hypertension.
  • Hypertension defined by self-report (up to 18 years) and clinic visit measurements (up to 9 years).

Main Results:

  • Higher baseline HbA1c levels were associated with increased hypertension risk in both diabetic and non-diabetic individuals.
  • Prediabetic HbA1c levels (5.7-6.4%) independently predicted incident self-reported hypertension (HR 1.14) and visit-detected hypertension (HR 1.17).
  • Significant associations were observed even in participants without a prior diabetes diagnosis.

Conclusions:

  • Elevated HbA1c levels, including those in the prediabetic range, are linked to a higher risk of developing hypertension.
  • The known association between HbA1c and cardiovascular events may be partly explained by its role in hypertension development.
  • HbA1c serves as a valuable biomarker for predicting hypertension risk, even in the absence of diagnosed diabetes.
Abstract

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