Impact of Hypertension on Type 2 Diabetes in Mysore Population of South India

Abstract

Objective: The study aims to explore the prevalence of hypertension and its impact on Type 2 diabetes in a Mysore population of the Indian subcontinent. Methods: 636 participants volunteered for the study. Anthropometric measurements and blood pressure were recorded while plasma was analyzed for biochemical markers. The IDF and JNC 7 diagnostic criteria were followed to define diabetes and hypertension. Statistical Analyses: One-way analysis of variance, χ2-test and Logistic regression analysis were performed to assess differences of the mean, proportion and the independent effect of hypertension on the development of type 2 diabetes. Results: Hypertension was observed to be prevalent in 37.1% of the studied population with an insignificant gender difference. Rate of occurrence of hypertensives was found to be significantly higher in type 2 diabetes (51.9%), obese subjects (45.2%), long-term smokers (49%) and alcohol addicts (48%) than control groups. The risk of development of diabetes was significantly higher in hypertensives than normotensive. However, when creatinine and blood urea nitrogen were included in the model, the significance was nullified. Conclusions: The prevalence of type 2 diabetes and hypertension is increasing at an alarming rate. This study reveals that the significance of hypertension as a parameter in predicting the risk of type 2 diabetes was influenced by the renal function and lipid profile.

Share and Cite:

M. Salman, S. Dasgupta, C. D’Souza, D. Xaviour, B. Raviprasad, J. Rao and G. Lakshmi, "Impact of Hypertension on Type 2 Diabetes in Mysore Population of South India," International Journal of Clinical Medicine, Vol. 4 No. 12, 2013, pp. 561-570. doi: 10.4236/ijcm.2013.412097.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] G. S. Wild, G. Roglic, A. Green, R. Sicree and H. King, “Global Prevalence of Diabetes: Estimates for the Year 2000 and Projections for 2030,” Diabetes Care, Vol. 27, No. 5, 2004, pp. 1047-1053.
http://dx.doi.org/10.2337/diacare.27.5.1047
[2] B. Basnayar and L. Rajapasha, “Cardiovascular and Infectious Diseases in South Asia: The Double Whammy,” British Medical Journals, Vol. 328, No. 7443, 2004, p. 781. http://dx.doi.org/10.1136/bmj.328.7443.781
[3] D. Yach, C. Hawkes, C. L. Gould and K. J. Hofman, “The Global Burden of Chronic Diseases: Overcoming Impediments to Prevention and Control,” Journal of the American. Medical Association, Vol. 291, No. 21, 2004, pp. 2616-2622.
http://dx.doi.org/10.1001/jama.291.21.2616
[4] A. Ramachandran, C. Snehalatha, A. Kapur, V. Vijay, V. Mohan, A. K Das, P. V. Rao, C. S. Yajnik, K. M. Prasanna Kumar and J. D. Nair, “Diabetes Epidemiology Study Group in India (DESI): High Prevalence of Diabetes and Impaired Glucose Tolerance in India: National Urban Diabetes Survey,” Diabetologia, Vol. 44, No. 9, 2001, pp. 1094-1101.
http://dx.doi.org/10.1007/s001250100627
[5] R. Klein, B. E. Klein, K. E. Lee, K. J. Cruickshanks and S. E. Moss, “The Incidence of Hypertension in Insulin Dependent Diabetes,” Archives of Internal Medicine, Vol. 156, No. 6, 1996, pp. 622-627.
http://dx.doi.org/10.1001/archinte.1996.00440060042005
[6] D. Conen, P. M. Ridker, S. Mora, J. E. Buring and R. J. Glynn, “Blood Pressure and Risk of Developing Type 2 Diabetes Mellitus: The Womens Health Study,” European Heart Journal, Vol. 28, No. 23, 2007, pp. 2937-2943. http://dx.doi.org/10.1093/eurheartj/ehm400
[7] P. W. Wilson, J. B. Meigs, L. Sullivan, C. S. Fox and D. M. Nathan and R. B. D’Agostino Sr, “Prediction of Incident Diabetes Mellitus in Middle-Aged Adults: The Framingham Offspring Study,” Archives of Internal Medicine, Vol. 167, No. 10, 2007, pp. 1068-1074.
http://dx.doi.org/10.1001/archinte.167.10.1068
[8] R. E. Aubert, L.S. Geiss, D. J. Ballard, B. Cocanougher and W. H. Herman, “Diabetes-Related Hospitalization and Hospital Utilization,” In: Diabetes in America, 2nd Edition, National Diabetes Information Clearinghouse, 1 Information Way, Bethesda, 1995, pp. 553-569.
[9] N. M. Kaplan and E. Lieberman, “Hypertension and Diabetes, Obesity, and Dyslipidaemia in Clinical Hypertension,” 7th Edition, New Delhi, B.I. Waverly Pvt. Ltd, 1998, pp. 244-247.
[10] UK Prospective Diabetes Study (UKPDS) Group, “Tight Blood Pressure Control and Risk of Macrovascular and Microvascular Complications in Type 2 Diabetes: UKPDS 39,” British Medical Journals, Vol. 317, No. 7175, 1998, pp. 703-713.
[11] UK Prospective Diabetes Study (UKPDS) Group, “Efficacy of Atenolol and Captopril in Reducing Risk of Macrovascular and Microvascular Complications in Type 2 Diabetes: UKPDS 39,” British Medical Journals, Vol. 317, No. 7160, 1998, pp. 713-720.
http://dx.doi.org/10.1136/bmj.317.7160.713
[12] A. Ramachandran, R. C. Ma and C. Snehalatha, “Diabetes in Asia,” Lancet, Vol. 375, No. 9712, 2010, pp. 408-418.
http://dx.doi.org/10.1016/S0140-6736(09)60937-5
[13] R. B. Singh, R. Beegom and V. Rastogi, “Clinical Characteristics and Hypertension among Known Patients of Non-Insulin Dependent Diabetes Mellitus in North and South Indians,” Journal of the Diabetic Association of India, Vol. 36, 1996, pp. 45-50.
[14] S. Jain and J. C. Patel, “Diabetes and Hypertension,” Journal of the Diabetic Association of India, Vol. 23, 1983, pp. 83-86.
[15] G. N. Dhobi, A. Majid, S. R. Masoodi, M. I. Bashir, A. I. Wani and A. H. Zargar, “Prevalence of Hypertension in Patients with New Onset Type 2 Diabetes Mellitus,” Journal of the Indian Medical Association, Vol. 106, No. 2, 2008, pp. 94-98.
[16] D. Akbar, M. M. Ahmed and A. A. Algamdi, “Cardiovascular Risk Factors in Saudi and Non-Saudi Diabetics,” Saudi Medical Journal, Vol. 24, No. 6, 2003, pp. 686-687.
[17] F. M. Mubarak, S. F. Erika, Y. J. Hashem and M. A. Kamel, “Hypertension among 1000 Patients with Type 2 Diabetes Attending a National Diabetes Center in Jordan,” Annals of Saudi Medicine, Vol. 28, No. 5, 2008, pp. 346-351. http://dx.doi.org/10.4103/0256-4947.51684
[18] S. Al-Moosa, S. Allin, N. Jemiai, J. Al-Lawati and E. Mossialos, “Diabetes and Urbanization in the Omani Population: An Analysis of National Survey Data,” Population Health Metrics, Vol. 24, No. 1, 2006, pp. 1-8.
[19] I. Satman, T. Yilmaz, A. Sengül, S. Salman, F. Salman, S. Uygur, I. Bastar, Y. Tütüncü, M. Sargin, N. Dinççag, K. Karsidag, S. Kalaça, C. Ozcan and H. King, “Population-Based Study of Diabetes and Risk Characteristics in Turkey,” Diabetes Care, Vol. 25, No. 9, 2002, pp. 1551-1556. http://dx.doi.org/10.2337/diacare.25.9.1551
[20] F. Al-Mahroos, K. Al-Roomi and P. M. McKeigue, “Relation of High Blood Pressure to Glucose Intolerance, Plasma Lipids and Educational Status in an Arabian Gulf Population,” International Journal of Epidemiology, Vol. 29, No. 1, 2000, pp. 71-76.
http://dx.doi.org/10.1093/ije/29.1.71
[21] C. H. Tseng, “Higher Risk of Hypertension in Indigenous Type 2 Diabetic Patients in Taiwan,” Journal of Hypertension, Vol. 24, No. 9, 2006, pp. 1817-1821.
http://dx.doi.org/10.1097/01.hjh.0000242406.76085.c4
[22] V. Baskar, D. Kamalakannan, M. R. Holland and B. M. Singh, “Does Ethnic Origin Have an Independent Impact on Hypertension and Diabetic Complications?” Diabetes, Obesity and Metabolism, Vol. 8, No. 2, 2006, pp. 214-219. http://dx.doi.org/10.1111/j.1463-1326.2005.00485.x
[23] V. Baskar, D. Kamalakannan, M. R. Holland and B. M. Singh, “The Prevalence of Hypertension and Utilization of Antihypertensive Therapy in a District Diabetes Population,” Diabetes Care, Vol. 25, No. 11, 2002, pp. 2107-2108. http://dx.doi.org/10.2337/diacare.25.11.2107
[24] M. Comaschi, C. Coscelli, D. Cucinotta, P. Malini, E. Manzato and A. Nicolucci, “Cardiovascular Risk Factors and Metabolic Control in Type 2 Diabetic Subjects Attending Outpatient Clinics in Italy: The SFIDA (Survey of Risk Factors in Italian Diabetic Subjects by AMD) Study,” Nutrition, Metabolism and Cardiovascular Diseases, Vol. 15, No. 3, 2005, pp. 204-211.
http://dx.doi.org/10.1016/j.numecd.2004.07.003
[25] F. J. Del Cañizo-Gómez and M. N. Moreira-Andrés, “Cardiovascular Risk Factors in Patients with Type 2 Diabetes. Do We Follow the Guidelines?” Diabetes Research and Clinical Practice, Vol. 65, No 2, 2004, pp. 125-133. http://dx.doi.org/10.1016/j.diabres.2003.12.002
[26] B. Y. Yuvraj, M. R. Nagendragowda and A. G. Umakantha, “Pevalence, Awaeness, Treatment and Control of Hypertension in Rural Areas of Davanagere,” Indian Journal of Community Medicine, Vol. 35, No. 1, 2010, pp. 138-241. http://dx.doi.org/10.4103/0970-0218.62578
[27] G. Dayananda and M. Niranjan, “Blood Pressure Changes in Normotensive Subjects with and without Family History of Hypertension,” Journal of Physiology and Biomedical Sciences, Vol. 22, No. 1, 2009, pp. 35-37.
[28] H. Basavanagowdappa, A. K. Prabhakar, P. Prasannaraj, K. C. Gurudev, Virupaksha and Suma, “Study of Prevalence of Diabetes Mellitus and Impaired Fasting Glucose in a Rural Population,” International Journal of Diabetes Developing Countries, Vol. 25, No. 4, 2005, pp. 98-101.
http://dx.doi.org/10.4103/0973-3930.27012
[29] C. Muninarayana, G. Balachandra, S. G. Hiremath, I. Krishna and N. S. Anil, “Prevalence and Awareness Regarding Diabetes Mellitus in Rural Tamaka, Kolar,” International Journal of Diabetes Developing Countries, Vol. 30, No. 1, 2010, pp. 18-31.
[30] C. R. Rao, V. G. Kamath, A. Shetty and A. Kamath, “A Study on the Prevalence of Type 2 Diabetes in Coastal Karnataka,” International Journal of Diabetes Developing Countries, Vol. 30, No. 2, 2010, pp. 80-85.
[31] S. Pushpa Patil, R. Umesh Dixit and B. H. Dhruvkumar, “Study of Diabetes in Dharwad—An Urban Area in India,” Indian Journal of Science and Technology, Vol. 4, No. 11, 2011, pp. 1481-1483.
[32] M. A. Shekar, H. M. Somashekar and B. S. Vishwanath, “Study of Incidence of Obesity in Newly Diagnosed Type 2 Diabetics Using Anthropometric Measurements,” International Journal of Diabetes Developing Countries, Vol. 25, No. 4, 2005, pp. 102-104.
[33] C. K. Priyankaraj and M. M. Angadi, “Hospital-Based KAP Study on Diabetes in Bijapur, Karnataka,” Indian Journal of Medical Specialities, Vol. 1, No. 2, 2010, pp. 80-83.
[34] World Health Organization, “Physical Status: The Use and Interpretation of Anthropometry. Report of the WHO Expert Committee,” World Health Organization Technical Report Series, Vol. 854, Geneva, 1995, pp. 1-416.
[35] World Health Organization, “Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation,” World Health Organization Technical Report Series, Vol. 894, 2000, pp. 1-253.
[36] A. V. Chobanian, G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo Jr., D. W. Jones, B. J. Materson, S. Oparil, J. T. Wright Jr. and E. J. Roccella, “The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report,” Journal of the American Medical Association, Vol. 289, No. 19, 2003, pp. 2560-2572. http://dx.doi.org/10.1001/jama.289.19.2560
[37] K. G. Alberti and P. Z. Zimmet, “Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications. Part 1: Diagnosis and Classification of Diabetes Mellitus Provisional Report of a WHO Consultation,” Diabetic Medicine, Vol. 15, No. 7, 1998, pp. 539-553.
http://dx.doi.org/10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S
[38] D. M. Nathan, D. E. Singer, K. Hurxthal and J. D. Goodson, “The Clinical Information Value of the Glycosylated Hemoglobin Assay,” New England Journal of Medicine, Vol. 310, No. 6, 1984, pp. 341-346.
http://dx.doi.org/10.1056/NEJM198402093100602
[39] S. R. Joshi, B. Saboo, M. Vadivale, S. I. Dani, A. Mithal, U. Kaul, M. Badgandi, S. S. Iyengar, V. Viswanathan, N. Sivakadaksham, P. S. Chattopadhyaya, A. D. Biswas, S. Jindal, I.. A. Khan, B. K. Sethi, V. D. Rao and J. J. Dalal, “SITE Investigators Prevalence of Diagnosed and Undiagnosed Diabetes and Hypertension in India Results from the Screening India’s Twin Epidemic (SITE) Study,” Diabetes Technology and Therapeutics, Vol. 14, No. 1, 2012, pp. 8-15. http://dx.doi.org/10.1089/dia.2011.0243
[40] I. H. de Boer, B. Kestenbaum, T. C. Rue, M. W. Steffes, P. A. Cleary, M. E. Molitch, J. M. Lachin, N. S. Weiss and J. D. Brunzell, “Insulin Therapy, Hyperglycemia, and Hypertension in Type 1 Diabetes Mellitus,” Archives of Internal Medicine, Vol. 168, No. 17, 2008, pp. 1867-1873. http://dx.doi.org/10.1001/archinternmed.2008.2
[41] Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group, “Sustained Effect of Intensive Treatment of Type 1 Diabetes Mellitus on Development and Progression of Diabetic Nephropathy: The Epidemiology of Diabetes Interventions and Complications (EDIC) Study,” Journal of the American Medical Association, Vol. 290, No. 16, 2003, pp. 2159-2167.
http://dx.doi.org/10.1001/jama.290.16.2159
[42] T. M. Davis, I. M. Stratton, C. J. Fox, R. R. Holman and R. C. Turner, “UK Prospective Diabetes Study 22. Effect of Age at Diagnosis on Diabetic Tissue Damage during the First 6 Years of NIDDM,” Diabetes Care, Vol. 40, No. 9, 1997, pp. 1435-1441.
http://dx.doi.org/10.2337/diacare.20.9.1435
[43] C. C. Cowie and M. I. Harris, “Physical and metabolic characteristics of persons with diabetes,” In: M. I. Harris, Ed., Diabetes in America, 2nd edition, National Diabetes Information Clearinghouse, 1 Information Way, Bethesda, 1995, pp. 117-164.
[44] J. M. Sprafka, A. P. Bender and H. G. Jagger, “Prevalence of Hypertension and Associated Risk Factors among Diabetic Individuals: The Three-City Study,” Diabetes Care, Vol. 11, No. 1, 1988, pp. 17-22.
http://dx.doi.org/10.2337/diacare.11.1.17
[45] “Hypertension in Diabetic Study (HDS): 1. Prevalence of Hypertension in Newly Presenting Type 2 Diabetic Patients and the Association with Risk Factors for Cardiovascular and Diabetic Complications,” Journal of Hypertension, Vol. 11, No. 3, 1993 pp. 309-317.
http://dx.doi.org/10.1097/00004872-199303000-00012
[46] T. A. Hillier and K. L. Pedula, “Characteristics of an Adult Population with Newly Diagnosed Type 2 DM: The Relation of Obesity and Age of Onset,” Diabetes Care, Vol. 24, No. 9, 2001, pp. 1522-1527.
http://dx.doi.org/10.2337/diacare.24.9.1522
[47] S. G. Manfred, J. Eliezer and L. Yair, “Blood Pressure in Smokers and Nonsmokers: Epidemiologic Findings,” American Heart Journal, Vol. 111, No. 5, 1986, pp. 932-940.
http://dx.doi.org/10.1016/0002-8703(86)90645-9
[48] L. Duk-Hee, H. Myung-Hwa, K. Jang-Rak and R. J. David, “Effects of Smoking Cessation on Changes in Blood Pressure and Incidence of Hypertension A 4-Year Follow-Up Study,” Hypertension, Vol. 37, No. 2, 2001, pp. 194-198. http://dx.doi.org/10.1161/01.HYP.37.2.194
[49] W. O. Balogun and B. L. Salako, “Co-Occurrence of Diabetes and Hypertension: Pattern and Factors Associated with Order of Diagnosis among Nigerians,” Annals of Ibadan Postgraduate Medicine, Vol. 9, No. 2, 2011, pp. 89-93.
[50] J. M. Brun, “What Is the Purpose to Asses Trigliceridemia during Treatment of NIDDM?” Diabetes and Metabolism, Vol. 23, No. 3, 1997, pp. 258-263.
[51] G. M. Reaven, H. Lithell and L. Landsberg, “Hypertension and Associated Metabolic Abnormalities—The Role of Insulin Resistance and the Sympathoadrenal System,” New England Journal of Medicine, Vol. 334, No. 6, 1996, pp. 374-381.
http://dx.doi.org/10.1056/NEJM199602083340607
[52] R. Pramiladevi, S. M. Gooranavar, S. B. Biradar, M. C. Baragundi, S. A. Kora and M. Narayan, “Study of Lipid Profile in Hypertensive Patients in Rural Karnataka,” Journal of Pharmaceutical And Biomedical Sciences, Vol. 7, No. 18, 2011, pp. 1-6.
[53] S. J. Jogalekar, “Co-Existence of Hypertension and Abnormal Lipid Profile, a Hospital Based Retrospective Survey,” Indian Heart Journal, Vol. 49, No. 3, 1997, pp. 275-278.
[54] A. S. Hakim, S. A. Kamath and Mamata, “A Retrospective Study of Lipid Profile in 500 Hypertensive Patients,” Journal of the Association of Physicians of India, Vol. 45, No. 12, 1997, pp. 943-944.
[55] A. J. Kirtane, D. M. Leder, S. S. Waikar, G. M. Chertow, K. K. Ray, D. S. Pinto, D. Karmpaliotis, A. J. Burger, S. A. Murphy, C. P. Cannon, E. Braunwald and C. M. Gibson, “Serum Blood Urea Nitrogen as an Independent Marker of Subsequent Mortality among Patients with Acute Coronary Syndromes and Normal to Mildly Reduced Glomerular Filtration Rates,” Journal of the American College of Cardiology, Vol. 45, No. 11, 2005, pp. 1781-1786. http://dx.doi.org/10.1016/j.jacc.2005.02.068
[56] R. Ostfeld, D. Mookherjee, M. Spinelli, D. Holtzman, A. Shoyeb, M. Schaefer, S. Doddamani, D. Spevack and Y. Du, “A Triglyceride/High-Density Lipoprotein Ratio >or = 3.5 Is Associated with an Increased Burden of Coronary Artery Disease on Cardiac Catheterization,” Journal of the Cardiometabolic Syndrome, Vol. 1, No. 1, 2006, pp. 13-15.
http://dx.doi.org/10.1111/j.0197-3118.2006.05323.x
[57] P. E. Tummala, X. L. Chen, C. L. Sundell, J. B. Laursen, P. Hammes, R. W. Alexander, D. G. Harrison and R. M. Medford, “Angiotensin II Induces Vascular Cell Adhesion Molecule-1 Expression in Rat Vasculature,” Circulation, Vol. 100, No. 11, 1999, pp. 1223-1229.
http://dx.doi.org/10.1161/01.CIR.100.11.1223
[58] S. B. Manuck, J. R. Kaplan, M. R. Adams and T. B. Clarkson, “Effects of Stress and the Sympathetic Nervous System on Coronary Atherosclerosis in the Cynomolgus Macaque,” American Heart Journal, Vol. 116, No. 1, 1988, pp. 328-333.
http://dx.doi.org/10.1016/0002-8703(88)90110-X
[59] A. Rozanski, J. A. Blumenthal and J. Kaplan, “Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy,” Circulation, Vol. 99, 1999, pp. 2192-2217.
http://dx.doi.org/10.1161/01.CIR.99.16.2192
[60] V. S. Joe, P. Tiffany, J. K. Andrew, A. Mark, S. Stephen, L. Jean, A. Arnold and D. Pettitt, “High Rates of Co-Occurrence of Hypertension, Elevated Low-Density Lipoprotein Cholesterol, and Diabetes Mellitus in a Large Managed Care Population,” American Journal of Managed Care, Vol. 10, No. 2, 2004, pp. 163-170.
[61] Y. L. Won, H. K. Chang, J. R. Eun, B. P. Jeong, K. K. Young and Y. W. Sook, S. Kim and K. C. Sung, “The Effect of Body Mass Index and Fasting Glucose on the Relationship between Blood Pressure and Incident Diabetes Mellitus: A 5-Year Follow-Up Study,” Hypertension Research, Vol. 34, No. 10, 2011, pp. 1093-1097.
http://dx.doi.org/10.1038/hr.2011.89
[62] T. W. Gress, F. J. Nieto, E. Shahar, M. R. Wofford and F. L. Brancati, “Hypertension and Antihypertensive Therapy as Risk Factors for Type 2 Diabetes Mellitus. Atherosclerosis Risk in Communities Study,” New England Journal of Medicine, Vol. 342, No. 13, 2000, pp. 905-912. http://dx.doi.org/10.1056/NEJM200003303421301
[63] C. David, M. R. Paul, M. Samia, E. B. Julie and J. G. Robert, “Blood Pressure and Risk of Developing Type 2 Diabetes Mellitus: The Women’s Health Study,” European Heart Journal, Vol.28, No. 23, 2007, pp. 2937-2943. http://dx.doi.org/10.1093/eurheartj/ehm400
[64] C. Josef, W. G. Laura, M. Geraldine, L. B. Fredrick, S. L. Andrew, J. Camille and J. K. Michael, “Prevalence of High Blood Pressure and Elevated Serum Creatinine Level in the United States,” Archives of Internal Medicine, Vol. 161, No. 9, 2001, pp. 1207-1216.
http://dx.doi.org/10.1001/archinte.161.9.1207
[65] “Hypertension in Diabetes Study (HDS), II. Increased Risk of Cardiovascular Complications in Hypertensive Type 2 Diabetic Patients,” Journal of Hypertension, Vol. 11, No. 3, 1993, pp. 319-325.
http://dx.doi.org/10.1097/00004872-199303000-00013
[66] G. Hu, J. Pekka and T. Jaakko, “Joint Effects of History of Hypertension at Baseline and Type 2 Diabetes at Baseline and during Follow-Up on the Risk of Coronary Heart disease,” European Heart Journal, Vol. 28, No. 24, 2007, pp. 3059-3066.
http://dx.doi.org/10.1093/eurheartj/ehm501

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.