Commentary: Heart rate and blood pressure: risk factors or risk markers?

In this issue of the Journal, Nagaya and colleagues 1 tested whether resting blood pressure and heart rate are each associated with the development of type 2 diabetes in middle-aged adults. The novelty of their study is the hypothesis that elevated blood pressure and heart rate are involved in the development of type 2 diabetes. Having failed to reject the null hypothesis of no association, the authors conclude that ‘resting heart rate and BP [blood pressure] ... proportionately raise the risk for development of DM [diabetes mellitus] in middle-aged healthy men and women’. 1 However, it is not clear whether such