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

Introduction 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 Methods 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. Results 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. Discussion 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.