Association between changes in systolic blood pressure and the incidence of diabetes mellitus: a retrospective study based on the Korean National Health Screening Cohort.

Background: As the global prevalence of diabetes mellitus continues to increase, it is important to identify its risk factors and implement preventive approaches. This study aimed to investigate the association between changes in systolic blood pressure (SBP) and the incidence of diabetes. Methods: Data from 152,547 participants, who underwent two consecutive health checkups between 2002 and 2003, and 2004 and 2005, and included in the Korean National Health Insurance Service Health Screening Database, were reviewed. Participants were divided into three groups according to change in SBP: decrease (≥10 mm Hg); no change (<10 mm Hg); and increase (≥10 mm Hg). Cox proportional hazard regression models for diabetes incidence were constructed to evaluate adjusted hazard ratio (HR) with corresponding 95% confidence interval (CI). Results: The median follow-up was 14.3 years, and 26,352 patients with diabetes were identified. Compared to those with no change in SBP, the adjusted HRs for decrease and increase among males were 1.06 (95% CI, 1.02-1.10) and 1.10 (95% CI, 1.06-1.14), and 1.06 (95% CI, 1.00-1.12) and 1.08 (95% CI, 1.02-1.13) for females, respectively. After stratifying data according to SBP at baseline, the HRs for decrease in males and females were as follows: normotensive group, 1.16 (95% CI, 1.08-1.24) and 1.11 (95% CI, 1.02-1.21); and prehypertensive group, 1.14 (95% CI, 1.09-1.20) and 1.19 (95% CI, 1.10-1.29), respectively. Conclusion: Changes in SBP were associated with a risk for diabetes.