title: Insulin resistance and hypertension: the Insulin Resistance Atherosclerosis study.
abstract: The association between insulin resistance and insulinemia and hypertension is controversial. We examined the relation between insulin resistance and hypertension in 564 non-Hispanic whites (NHW), 505 Hispanics (H), and 413 African Americans (AA) who participated in the Insulin Resistance Atherosclerosis Study (IRAS). Insulin sensitivity was measured with a frequently sampled intravenous glucose tolerance test with minimal model analysis. The prevalence of hypertension was 32.5%, 49.4%, and 32.3% in NHW, AA, and H, respectively (P<0.001). When subjects without diabetes in all ethnic groups were combined, age, male sex, race (AA), body mass index (BMI), and insulin resistance, but not fasting insulin, were significantly associated with hypertension. When each ethnic group was analyzed separately, insulin resistance was significantly associated with hypertension in NHW and H, but not AA. After excluding subjects taking antihypertensive medications, male sex, BMI, fasting glucose, and insulin resistance, but not fasting insulin, were significant determinants of blood pressure. When the 3 ethnic groups were analyzed separately, insulin resistance was significantly associated with blood pressure in H, but not NHW, or AA. Neither insulin resistance nor fasting insulin was significantly associated with hypertension or blood pressure in subjects with diabetes of the 3 ethnic groups after adjusting for age, sex, BMI, and waist. In conclusion, insulin resistance, but not insulinemia, was related to hypertension and blood pressure in subjects without diabetes, but ethnic differences in these relations appear to exist. Neither insulin resistance nor insulinemia was related to hypertension or blood pressure in patients with type 2 diabetes in the 3 ethnic groups.
authors.affiliation: Division of Clinical Epidemiology, Department of Medicine, UCLA Medical School, 924 Westwood Blvd, Suite 335 (Mail Box 15), Los Angeles, Calif 90024, USA. msaad@mednet.ucla.edu
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Saad
authors.forename: Marian
authors.initials: M
authors.lastname: Rewers
authors.forename: Joseph
authors.initials: J
authors.lastname: Selby
authors.forename: George
authors.initials: G
authors.lastname: Howard
authors.forename: Sujata
authors.initials: S
authors.lastname: Jinagouda
authors.forename: Salwa
authors.initials: S
authors.lastname: Fahmi
authors.forename: Dan
authors.initials: D
authors.lastname: Zaccaro
authors.forename: Richard N
authors.initials: RN
authors.lastname: Bergman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Savage
authors.forename: Steven M
authors.initials: SM
authors.lastname: Haffner
mesh_terms: D001741:Black or African American; D001161:Arteriosclerosis / Q000453:epidemiology* / Q000208:ethnology; D001794:Blood Pressure; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006630:Hispanic or Latino; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology / Q000208:ethnology; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D013781:Texas / Q000453:epidemiology; D044465:White People
chemical_list: D007328:Insulin