WASHINGTON — The increased risk for essential hypertension in patients with type 2 diabetes is apparent throughout the entire lifespan, Dr. Scott J. Jacober and his associates reported in a poster at the annual scientific sessions of the American Diabetes Association.
The relationship is exceptionally strong among children and adolescents, said Dr. Jacober, who was with Lilly Research Laboratories, Indianapolis, at the time of the study.
Essential hypertension and type 2 diabetes often coexist, but this retrospective study of a nationwide electronic medical records database is believed to be the first to examine the prevalence of essential hypertension by age group among individuals with and without diabetes, he noted.
The database contained more than 4 million patients, and the study population, from 49 states during 1996–2005, comprised 231,492 individuals with a physician's diagnosis of type 2 diabetes in their records.
Patients with type 1 diabetes were excluded. The study also included 1,219,047 people who did not have type 2 diabetes.
Overall, essential hypertension was diagnosed in 63% of patients with type 2 diabetes, compared with 40% of those without.
The increase in risk was less striking in adults than in children and adolescents, but it remained statistically significant for all adult age groups even after adjustment for age, gender, geographic region, and five comorbid conditions (obesity, hyperlipidemia, nephritis, ischemic heart disease, and other forms of heart disease).
Among the 2,808 young adults aged 20–29, essential hypertension was present in 21% of those with type 2 diabetes vs. 7.3% of those without, with a 50% increased risk for essential hypertension after adjustment for other factors.
Overall, the prevalence of essential hypertension among diabetic adults increased by decade of life from 36% at ages 30–39 to 70% at ages 70–79, dropping slightly thereafter to 67% among people over 80 years of age.
Among the nondiabetics, essential hypertension was present in 19.5% of the 30- to 39-year-olds, rising to 60% for those aged 70–79, and again dropping slightly thereafter to 58%. The adjusted odds ratio by decade between the diabetics and nondiabetics remained the same, at 1.3, for adults aged 30 and older, Dr. Jacober and his associates reported.
The risk differential was striking among children younger than age 12 years. Essential hypertension was present in 26.3% of the 219 children with type 2 diabetes, compared with just 0.5% of the 49,984 without, for an unadjusted odds ratio of 56.1.
Even after adjustment for the other risk factors, children aged 0–11 years with type 2 diabetes still were more than 20 times more likely than those without to have essential hypertension, Dr. Jacober and his colleagues reported.
Among adolescents aged 12–19 years, essential hypertension was present in 9.7% of the 691 with type 2 diabetes vs. 1.8% of the 61,129 without. In this age group, the unadjusted odds ratio was 4.4 and the adjusted odds ratio was 2.3, also highly significant.