In Normoglycemic Koreans, Insulin Resistance and Adipocity are Independently Correlated With High Blood Pressure

Abstract

yperinsulinemia is known to be associated with various cardiovascular risk factors, including high triglyceride concentrations, low high-density lipoprotein (HDL) cholesterol concentrations, high blood pressure (BP), and obesity. 1-3 However, there is some controversy about the role of insulin resistance (IR) in the regulation of BP. Several prospective studies have linked insulin concentrations to the incidence of hypertension [4][5][6] and it has been suggested that hyperinsulinemia and/or IR plays a role in the pathophysiology of hypertension. [7][8][9][10][11] But the association between insulin and hypertension remains contentious, 12 with a number of studies reporting no association between insulin and BP. 13,14 Moreover, to our knowledge a large study of the association between BP and IR has not been conducted in normal glucose tolerance Asians. Therefore, we decided to investigate the relationships between BP and IR using a homeostasis model (HOMA-IR) and further, to evaluate the association between body fat distribution and high BP in nondiabetic normoglycemic Koreans. Methods Subjects and MeasurementsThe total number of subjects involved was 53,477, all of whom presented for a routine health status check up at the Kangbook Samsung Hospital, College of Medicine in Sungkyunkwan University in 2002, and who were without specific medical complaints. Based on the results obtained, patients suspected of having acute inflammatory diseases, other malignancies and those taking BP-lowering medication were excluded. In addition we also excluded those taking antidiabetic agents and those with a fasting glucose over 110 mg/dl. Finally, 49,076 subjects (31,820 men; 17,256 women) were included in this study. Anthropometric indices of adiposity, metabolic variables (including fasting serum insulin and homeostasis model assessment (HOMA) index of insulin sensitivity), BP and several cardiovascular risk factors were measured. The BP was determined using a mercury manometer, between 08.00 h and 10.00 h, after the subject had been sitting upright for at least 10 min.When the systolic or diastolic BP exceeded 140 mmHg or 90 mmHg, it was re-measured twice after a rest and averaged. A high BP was defined as a SBP ≥140 mmHg or a DBP ≥90 mmHg.The body mass index (BMI: kg/m 2 ), the waist circumference and the waist -hip ratio were also measured. The subjects were asked questions concerning the risk factors for general cardiovascular disease (ie, past medical history, life style, such as alcohol consumption, smoking, and Background There is some controversy about the role of insulin resistance (IR) in the regulation of blood pressure (BP). Moreover, a large study of the association between BP and IR has not been conducted in normal glucose tolerance Asians. The present study investigated the relationships between IR, body mass index (BMI) and waist circumference and BP in normoglycemic Koreans. Methods and ResultsAnthropometric indices of adiposity, metabolic variables (fasting serum insulin and a homeostasis model assessment (H...

Predictors of successful long-term blood pressure control in type 2 diabetic patients: data from the Swedish National Diabetes Register (NDR)

“…Increased insulin sensitivity has also been found in hypertensive patients with normal mean BMI [20]. Conversely, others have found cross-sectionally that elevated BMI, waist circumference and insulin resistance are associated with high BP [21], and that the insulin resistance is directly correlated to the severity of hypertension [22]. It has also been suggested that a lower BMI might be associated with a decreased sodium retention by the kidney, related to serum insulin levels or other factors [20].…”

A Positive Association between Leptin and Blood Pressure of Normal Range in Japanese Men

“…First, insulin resistance and insulin concentration are also associated with blood pressure ( 19 ). Insulin and leptin are reported to cooperate in the modulation of vascular tone ( 20 -22 ), and insulin has been shown to stimulate leptin production ( 23 ).…”

Relationship between thyroid-stimulating hormone and blood pressure in the middle-aged and elderly population

“…The study population was originally recruited during a health survey on the prevalence of thyroid disease and diabetes mellitus in the district of Baoshan in Shanghai, China. Since existing research conducted in other populations have suggested that insulin resistance may also be associated with blood pressure, (7,8) we investigated the relationships among serum TSH level, insulin resistance and blood pressure. …”