Association of hypertension and incident diabetes in Chinese adults: a retrospective cohort study using propensity-score matching

Abstract

Background Reliable quantification of the relationship between hypertension and diabetes risk is limited, especially among Chinese people. We aimed to investigate the association between hypertension and the risk of diabetes in a large cohort of the Chinese population. Methods This was a retrospective propensity score-matched cohort study among 211,809 Chinese adults without diabetes at baseline between 2010 and 2016. The target independent and dependent variable were hypertension at baseline and incident diabetes during follow-up respectively. The propensity score matching using a non-parsimonious multivariable logistic regression was conducted to balance the confounders between 28,711 hypertensive patients and 28,711 non-hypertensive participants. The doubly robust estimation method was used to investigate the association between hypertension and diabetes. Results In the propensity-score matching cohort, diabetes risk increased by 11.0% among hypertensive patients (HR\u2009=\u20091.110, 95% confidence interval (CI): 1.031–1.195, P \xa0=\u20090.00539). And diabetes risk dropped to 8.3% among hypertensive subjects after adjusting for the propensity score (HR\u2009=\u20091.083, 95%CI: 1.006–1.166, P \u2009=\u20090.03367). Compared to non-hypertensive participants with low propensity score, the risk of incident diabetes increased by 2.646 times among hypertensive patients with high propensity score (HR\u2009=\u20093.646, 95%CI: 2.635–5.045, P \u2009<\u20090.0001). Conclusion Hypertension was associated with an 11.0% increase in the risk of developing diabetes in Chinese adults. And the figure dropped to 8.3% after adjusting the propensity score. Additionally, compared to non-hypertensive participants with low propensity scores, the risk of incident diabetes increased by 2.646 times among hypertensive patients with high propensity scores.