Insulin Resistance and Risk of Incident Hypertension Among Men

Abstract

The independent association between insulin resistance and the development of hypertension remains in doubt because insulin resistance correlates with other metabolic factors also proposed to be associated with hypertension. The authors examined the association between the insulin sensitivity index and incident hypertension in a prospective nested case-control study among 1453 men (mean age, 61 years) who participated in the Health Professionals' Follow-up Study. The authors computed the insulin sensitivity index for each man in the study based on fasting insulin and triglyceride levels. Logistic regression was performed conditioned on age and adjusted for standard hypertension risk factors as well as renal function, cholesterol, and uric acid. The insulin sensitivity index was 6% lower in the cases compared with the controls (P<.001). The multivariable odds ratio for hypertension comparing the lowest with highest quartile of insulin sensitivity index was 1.09 (0.71-1.65) among the entire sample. However, the association between the insulin sensitivity index and incident hypertension differed significantly by age (P interaction <.001). Among men younger than 60 years, the multivariable odds ratio for the lowest compared with highest quartile was 1.93 (1.01-3.71) but was 0.67 (0.37-1.24) among older men. Insulin resistance is independently associated with incident hypertension among younger men.

Effect of age and sex on the associations between potential modifiable risk factors and both type 2 diabetes and impaired fasting glycaemia among West African adults

“…Furthermore, our finding of statistically significant interaction with age for the association between hypertension and T2DM can be ascribed to the evidence that hypertension increases with age and is also concordant with previous studies among different population groups [ 38 , 39 ]. For example, in a prospective study among the US population [ 39 ], Lai et al [ 39 ], showed a positive interaction with age for the association between insulin sensitivity index and incident hypertension. Similar findings were reported among the Chinese population, in a study by Wan et al [ 38 ].…”

“…It is unclear, however, in the current study as in previous observational studies [ 38 , 39 ] if the associations observed are causal. Although a meta-analysis of prospective studies by Emodin et al [ 40 ] postulates that participants with elevated HBP are at increased risk of T2DM, longitudinal studies among populations from the UK [ 41 ], China [ 38 ], and the US [ 42 ], showed that T2DM may be in the causal pathway of hypertension whereas the opposite was not likely.…”

Prehypertension in dyslipidemic individuals; relationship to metabolic parameters and intima-media thickness

“…[43][44][45] ). However, not insulinemia alone but insulin resistance is usually related to blood pressure in prehypertensive and hypertensive patients and it is able to predict incident hypertension [46][47][48] . There was not found correlation between insulin levels and BP in the present study, too.…”

Insulin resistance, metabolic syndrome, and blood pressure progression among Blacks: the Jackson Heart Study

“…There is a dearth of data on the relations of insulin resistance measures and incident BP changes and among Blacks; with prior studies conducted in samples with no or a very limited number of Black individuals [7][8][9][10][11][12][13][14][15][16]. To our knowledge, no prior study has assessed the relation of insulin resistance and longitudinal BP changes in a sample made exclusively of Blacks.…”