Prevalence of Prediabetes and Risk of CVD Mortality in Individuals with Prediabetes Alone or Plus Hypertension in Northeast China: Insight from a Population Based Cohort study

Abstract

Abstract Background To evaluate the current prevalence of prediabetes in northeast China, and further to determine the association between prediabetes alone or coexistent with hypertension and cardiovascular diseases (CVD) mortality. Methods In the prospective study, 15557 participants without diabetes among aged ≥ 40 years in northeast China, were followed for a median of 3.3 years. Following American Diabetes Association, prediabetes was defined as fasting plasma glucose (FPG) range of 5.6–6.9 mmol/L or HBA1C range of 5.7–6.4% in people without diabetes . Results The prevalence of prediabetes were 44.3% among population aged ≥ 40 years in northeast China. Prediabetes alone did not promote risk of CVD mortality. However, when the subgroups were stratified by hypertension, the CVD mortality risk in prediabetes plus hypertension subjects increased significantly compared with population without prediabetes and hypertension. Multivariate-adjusted hazard ratios for CVD mortality in prediabetes subgroups plus hypertension were 3.33 for those diagnosed by FPG 5.6-6.0 mmol/L and 3.92 for diagnosis by FPG 6.1-6.9mmol/L, and increased to 4.16 for diagnosis by HbA1c 5.7–6.4% alone compared with the reference group. Moreover, the percentage of hypertension in prediabetes subjects was high (60.4%), but the awareness, treatment and control rates were far from satisfactory (45.3%, 35.1% and 4.8%, respectively). Conclusions The prevalence of prediabetes remains high in northeast China, and the CVD mortality was elevated significantly in prediabetes coexistent with hypertension. Considering the high percentage and low control rate of hypertension in prediabetes, strategies focus on HbA1c screening, FPG lowering and blood pressure management should be emphasized in northeast China.