title: Insulin resistance, body mass index, waist circumference are independent risk factor for high blood pressure.
abstract: OBJECTIVE
  The purpose of the present study was to investigate the relationships between blood pressure (BP), insulin resistance as determined by a homeostasis model (HOMA-IR), and body fat distribution.
  
  
  METHODS
  Anthropometric indices of adiposity, metabolic variables (fasting serum insulin and a homeostasis model assessment [HOMA] index of insulin sensitivity), BP and several cardiovascular risk factors were measured during a cross sectional survey of 53477 apparently healthy Korean subjects who requested a health status check. Hypertension was defined as a systolic BP > or = 140 mmHg or a diastolic BP > or = 90 mmHg and we excluded the subjects taking BP-lowering medication.
  
  
  RESULTS
  Systolic and diastolic blood pressure (SBP, DBP) were positively and significantly associated with age, body mass index, waist circumference, and waist/hip ratio. In addition, SBP and DBP were positively associated with fasting serum insulin levels and the HOMA index. By multiple regression analysis age, waist circumference, body mass index, HOMA index and female sex were independently associated with either increased SBP or DBP. When the population is divided into quintiles according to insulin resistance (measured by HOMA analysis) prevalence of hypertension in the second, third, fourth and fifth quintiles compared to subjects in the first quintile are 1.004(95% CI 0.875-1.152, p = 0.957), 1.200(95% CI 1.052-1.369, p = 0.007), 1.312(95% CI 1.151-1.494 p < 0.001 ), and 1.603(95% CI 1.408-1.825 p < 0.001). In addition age, sex, body mass index and waist circumference were found to be significantly associated with hypertension.
  
  
  CONCLUSIONS
  Our results showed that insulin resistance, body mass index and waist circumference are independent risk factors of a high BP in Koreans.
authors.affiliation: Division of Cardiology, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, South Korea. mdkcsung@samsung.co.kr
authors.forename: Ki Chul
authors.initials: KC
authors.lastname: Sung
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Ryu
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D049629:Waist-Hip Ratio