# The association between family history of hypertension and diabetic kidney disease in patients with diabetes: a cross-sectional study

## TL;DR

This study finds that a family history of hypertension is linked to a higher risk of diabetic kidney disease in people with type 2 diabetes.

## Contribution

The study provides new evidence that family history of hypertension is independently associated with diabetic kidney disease in T2D patients.

## Key findings

- A family history of hypertension was associated with 2.57 times higher odds of DKD after propensity score matching.
- Similar significant associations were observed using inverse probability of treatment weighting and other methods.
- The association remained robust across sensitivity analyses, suggesting a strong link between familial hypertension and DKD.

## Abstract

The contribution of a family history of hypertension (HH) to diabetic kidney disease (DKD) pathogenesis remains unclear. Investigating this association is crucial for refining risk stratification and enabling early intervention in patients with type 2 diabetes (T2D). This study examined whether a HH is associated with higher odds of DKD among individuals with T2D

Participants with T2D were grouped according to the presence or absence of a family history of hypertension. Propensity score matching (PSM) was used to mitigate potential confounding factors from baseline clinical features across the comparative groups. To evaluate robustness against confounding and missingness, we applied multivariable logistic regression and E-value analysis and then performed PSM on the dataset after multiple imputation.

The final analytical data comprised 1,612 individuals fulfilling the diagnostic criteria for T2D, comprising 1,419 without HH and 193 with HH. After PSM, 386 patients (193 patients per group) were included. PSM analysis yielded an odds ratio (OR) of 2.57 (95% CI: 1.48–4.46, P = 0.001). Similar estimates were obtained using inverse probability of treatment weighting (OR = 2.18, 95% CI: 1.52–3.13, P < 0.001) and other weighting approaches. The key findings maintained statistical significance throughout sensitivity testing.

In this cross-sectional study, a history of familial hypertension was significantly associated with higher odds of DKD in individuals with T2D. Given the cross-sectional design, causality and temporal direction cannot be established; prospective studies are needed to determine whether familial hypertension contributes to DKD development and progression.