Adults with type 2 diabetes mellitus (T2DM) and young-onset hypertension (YOH) faced greater cardiovascular and kidney risks than those with late-onset hypertension (LOH), according to a retrospective cohort study published in the journal Diabetes Care.

The analysis included 19,224 individuals with YOH and 57,795 with LOH, each matched with corresponding control participants without hypertension by age, sex, diabetes duration, and calendar year. Cox proportional hazards regression models were used to evaluate cardiovascular disease (CVD), chronic kidney disease, end-stage kidney disease, congestive heart failure, and all-cause mortality outcomes.

Findings

• CVD risk was higher in the YOH group (HR 1.83; 95% CI, 1.65-2.03) than in the LOH group (HR 1.43; 95% CI, 1.36-1.50) compared with matched controls (P for interaction <0.01).
• Chronic kidney disease risk exceeded two-fold in the YOH group (HR 2.58; 95% CI, 2.38-2.80), compared with an 81% increase in the LOH group (HR 1.81; 95% CI, 1.75-1.88).
• Congestive heart failure risk was higher in the YOH group (HR 2.58; 95% CI, 1.92-3.47) than in the LOH group (HR 1.81; 95% CI, 1.61-2.03).
• All-cause mortality risk was modestly higher in the YOH group (HR 1.37; 95% CI, 1.22-1.54) compared with the LOH group (HR 1.31; 95% CI, 1.25-1.37).
• Differences in excess cardiovascular and coronary heart disease risks between YOH and LOH were more pronounced in women than in men (P for three-way interaction <0.05).

These findings suggest that young-onset hypertension may confer greater cardiovascular and kidney risks than late-onset hypertension in adults with type 2 diabetes.