Effects of body mass index, plasma glucose and cholesterol levels on isolated systolic hypertension Gary T.C. Ko a,b, * , Clive S. Cockram b , Chun-Chung Chow b , Wing-Bun Chan b , Wing-Yee So b , Ronald Ma b , Riza Osaki b , Juliana C.N. Chan b a Department of Medicine, Alice Ho Nethersole Hospital, Tai Po, Hong Kong b Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong Received 11 November 2003; received in revised form 17 February 2004; accepted 5 March 2004 Available online 22 July 2004 Abstract Despite the high cardiovascular risk of diabetic patients, there is a paucity of data on isolated systolic hypertension (ISH) in diabetic patients. In this cross-sectional study, we examined the risk of ISH and its associated factors in Chinese type 2 diabetic patients. Isolated systolic hypertension was defined as systolic blood pressure (SBP) z140 mm Hg and diastolic blood pressure (DBP) b90 mm Hg. The mean value of two BP measurements taken 1 min apart was used. There were 1048 type 2 diabetic patients recruited from the Prince of Wales Hospital Diabetes Clinic. Another 1043 age- and sex-matched non-diabetic subjects were recruited from the community. The mean age of the 2091 subjects was 40.6F7.6 years (median: 40 years, range: 16–69 years). Diabetic patients had an increased risk of ISH compared to non-diabetic subjects (7.6% vs. 3.4%, pb0.001) with an odd ratio of 2.38. On multivariate analysis, age, body mass index, total cholesterol and duration of diabetes in diabetic subjects while age and waist–hip ratio (WHR) in non-diabetic subjects were independently associated with ISH. In conclusion, Chinese type 2 diabetic patients had increased risk to develop ISH than non-diabetic subjects. Age, obesity, lipid and duration of diabetes were independent associated with ISH. These findings suggest that control of body weight and metabolic profile might have beneficial effects on ISH. D 2004 Elsevier Ireland Ltd. All rights reserved. Keywords: Isolated systolic hypertension; Chinese; Type 2 diabetes mellitus; Body mass index; Hypercholesterolaemia 1. Introduction Large-scale epidemiological surveys have confirmed that systolic blood pressure (SBP) was more strongly associated with cardiovascular risk than diastolic blood pressure (DBP) [1–3]. Isolated systolic hypertension (ISH) is defined by an elevated SBP (z140–160 mm Hg) and normal DBP (b90 mm Hg) [4]. It is usually found in elderly who have degenerated and stiffened vasculatures [4–6]. With aging, arteries lose their elasticity with reduced compliance to stroke volume leading to increased SBP [6]. The loss of recoil of blood vessels also lead to increased DBP. 6 The lowest arterial capacitive compliance has been demonstrated in patients with ISH, followed by patients with essential hypertension (HT), while normo- tensive control subjects have the best vascular compliance [7]. Although patients with type 2 diabetes is well known to have HT, vasculopathy, endothelial dysfunction and cardi- ovascular diseases [8–10], there is only a paucity of data on the relationship between type 2 diabetes and ISH. In this study, we compared 1048 Chinese type 2 diabetic patients, and 1043 age- and sex-matched non-diabetic control subjects to assess the risk and determinants of ISH in Chinese patients with type 2 diabetes. 0167-5273/$ - see front matter D 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2004.03.059 * Corresponding author. Department of Medicine, Alice Ho Nethersole Hospital, 11, Chuen On Road, Tai Po, Hong Kong. Tel.: +852 2689 2255; fax: +852 2665 6436. E-mail address: gtc _ ko@hotmail.com (G.T.C. Ko). International Journal of Cardiology 101 (2005) 429 – 433 www.elsevier.com/locate/ijcard