title: High Blood Pressure and Its Association With Incident Diabetes Over 10 Years in the Korean Genome and Epidemiology Study (KoGES).
abstract: OBJECTIVE
  No prospective, community-based cohort studies have investigated the association between blood pressure and diabetes in Asian ethnicity. We investigated this issue in a 10-year prospective, community-based study of Koreans.
  
  
  METHODS
  We studied whether high blood pressure was associated with the development of diabetes in a population-based cohort, where we sampled ∼5,000 random subjects each from rural and urban areas (age range 40-69 years) during 2001-2010. Among 10,038 subjects, 8,359 without diabetes at baseline were categorized into normal (n = 4,809), prehypertension (n = 2,141), stage 1 hypertension (n = 804), and stage 2 hypertension (n = 605) groups, according to their blood pressure readings of <120/80 mmHg, 120-139/80-89 mmHg, 140-159/90-99 mmHg, and ≥160/100 mmHg, respectively. The development of diabetes was defined as a fasting glucose concentration of ≥126 mg/dL or a postload glucose concentration of ≥200 mg/dL, based on a 75-g oral glucose tolerance test, or the use of antidiabetic medication.
  
  
  RESULTS
  During the 10-year follow-up period, diabetes developed in 1,195 subjects (14.3%). The incidence of diabetes increased from 11.1% in the normal group to 17.0% in the prehypertension group, 17.7% in the stage 1 hypertension group, and 25.8% in the stage 2 hypertension group (P < 0.001). After adjusting for anthropometric factors; family history of diabetes; biochemical parameters including C-reactive protein, A1C, and fasting glucose and postload 2-h glucose levels; and the use of lipid-lowering medications, the hazard risks of diabetes development were 1.23 (95% CI 1.06-1.42), 1.26 (1.04-1.54), and 1.60 (1.30-1.96), respectively, in the prehypertension, stage 1 hypertension, and stage 2 hypertension groups.
  
  
  CONCLUSIONS
  Our findings indicate a grade association of baseline blood pressure with the development of diabetes in Korean individuals.
authors.affiliation: Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Nam H
authors.initials: NH
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyong Soo
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Hak Chul
authors.initials: HC
authors.lastname: Jang
authors.affiliation: Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongwon-gun, Republic of Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, U.K.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Republic of Korea limsoo@snu.ac.kr.
authors.forename: Soo
authors.initials: S
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000235:genetics / Q000706:statistics & numerical data*; D001794:Blood Pressure / Q000502:physiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors