Cardiometabolic & kidneyCross-sectional study
Hypertension Subtypes and Diabetes
- cohort analysis of National Health and Nutrition Examination Survey data
- mortality follow-up until 2019
- multivariable Cox regression
Authors' conclusion
HTN subtypes were significantly associated with increased CVD and all-cause mortality in patients with DM more strongly than in those without DM, suggesting greater importance of controlling all HTN subtypes in those with DM.
Study context
- Population
- Individuals from the National Health and Nutrition Examination Survey, with and without diabetes mellitus (DM)projected to 207 million, 12% (25 M) had DM
- Participants
- 52,385 individuals
- Exposure
- association of hypertension (HTN) subtypes with cardiovascular disease (CVD) and all-cause mortality, compared by DM status
Main finding
As reported in the abstract
Prevalence of HTN subtypes, with vs without DM
Normotensive
23% vs 57%
Isolated diastolic hypertension (IDH)
5% vs 9%
Isolated systolic hypertension (ISH)
39% vs 18%
Systolic-diastolic hypertension (SDH)
16% vs 13%
Observational data: associations, not effects.
Further findings
| Outcome | HR | P value |
|---|---|---|
| CVD and all-cause mortality in patients without DM — ISH · CVD · adjusted for age, sex, and other risk factors | 1.19 | P < 0.01 |
| CVD and all-cause mortality in patients without DM — ISH · all-cause mortality · adjusted for age, sex, and other risk factors | 1.15 | P < 0.01 |
| CVD and all-cause mortality in patients without DM — SDH · CVD · adjusted for age, sex, and other risk factors | 1.29 | P < 0.01 |
| CVD and all-cause mortality in patients without DM — SDH · all-cause mortality · adjusted for age, sex, and other risk factors | 1.18 | P < 0.01 |
| CVD and all-cause mortality in patients without DM — IDH · CVD · adjusted for age, sex, and other risk factors | 0.76 | P = 0.32 |
| CVD and all-cause mortality in patients without DM — IDH · all-cause mortality · adjusted for age, sex, and other risk factors | 0.86 | P = 0.20 |
| CVD and all-cause mortality in patients with DM — ISH · CVD · adjusted for age, sex, and other risk factors | 1.57 | P < 0.01 |
| CVD and all-cause mortality in patients with DM — ISH · all-cause mortality · adjusted for age, sex, and other risk factors | 1.46 | P < 0.01 |
| CVD and all-cause mortality in patients with DM — SDH · CVD · adjusted for age, sex, and other risk factors | 2.11 | P < 0.01 |
| CVD and all-cause mortality in patients with DM — SDH · all-cause mortality · adjusted for age, sex, and other risk factors | 1.68 | P < 0.01 |
| CVD and all-cause mortality in patients with DM — IDH · CVD · adjusted for age, sex, and other risk factors | 3.65 | P < 0.01 |
| CVD and all-cause mortality in patients with DM — IDH · all-cause mortality · adjusted for age, sex, and other risk factors | 1.97 | P < 0.01 |
- CVD and all-cause mortality in patients with DM: interaction P < 0.01 for all subtypes by DM status
Original publication
Hypertension Subtypes and Diabetes. JACC Adv. Published 24 February 2026. doi:10.1016/j.jacadv.2026.102603
Summarised from the published abstract; every number is checked against it