Hemoglobin A1c, Body Mass Index, and the Risk of Hypertension in Women

Abstract

Although basic research has implicated abnormal glucose metabolism in the pathogenesis of hypertension (HTN), epidemiologic studies are limited. We assessed whether baseline hemoglobin A1c (HbA1c) was prospectively associated with HTN in the Women’s Health Study (WHS). We analyzed 19,858 women initially free of HTN, diabetes, and cardiovascular disease (CVD) with baseline blood samples. We considered quintiles and clinical cutpoints of HbA1c for the risk of HTN, defined as either a new physician diagnosis, the initiation of antihypertensive treatment, or systolic blood pressure (SBP) ≥140 or diastolic blood pressure (DBP) ≥90 mm H g. During a median follow-up of 11.6 years, 9,408 (47.5%) women developed HTN. In models adjusted for traditional cardiovascular risk factors, the hazard ratios (HRs) from the lowest (American Journal of Hypertension advance online publication 9 December 2010; doi:10.1038/ajh.2010.233