Insulin resistance and prevalence of prehypertension and hypertension among community-dwelling persons.
OBJECTIVE
There are few data focusing on the effect of insulin resistance on a new risk category of prehypertension (120-139 mmHg systolic and/or 80-89 mmHg diastolic blood pressure) recently established by The Seventh Report of the Joint National Committee on High Blood Pressure (JNC-7). We aimed to determine whether insulin resistance was associated with a risk for prehypertension and hypertension.


METHODS
Of 3,164 (34.6% of 9,133 adults aged 19 to 90 years) adults at the community-based annual medical check-up, study participants without a clinical history of stroke, transient ischemic attack, myocardial infarction, angina, or renal failure (567 men aged 57+/-14 (mean+/-standard deviation); range, 20-84) years and 702 women aged 59+/-12; 21-88 years) were recruited. We examined the cross-sectional relationship between insulin resistance, which was evaluated by homeostasis of minimal assessment of insulin resistance (HOMA-IR) and normotension, prehypertension, or hyper-tension using the JNC-7 criteria.


RESULTS
The HOMA-IR correlated significantly with systolic (r=0.171) and diastolic (r=0.170) blood pressures. Triglycerides >or=150 mg/dL, HDL-C <40 mg/dL, metabolic syndrome, serum uric acid >or=7.0 mg/dL, and HOMA-IR >or=2.5 showed the highest crude odds ratio (OR) for progression from normotension to prehypertension, and >or=65 years, FBG >or=110 mg/dL, metabolic syndrome, and HOMA-IR >or=2.5 showed the highest crude OR for progression from normotension to hypertension. Multivariate logistic regression analysis showed that HOMA-IR was independently associated with the presence of prehypertension and hypertension.


CONCLUSIONS
Insulin resistance was significantly associated with prehypertension as well as hypertension in the general population.
Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan. rykawamo@ehime.med.or.jp
Ryuichi
R
Kawamoto
Katsuhiko
K
Kohara
Yasuharu
Y
Tabara
Masanori
M
Abe
Tomo
T
Kusunoki
Tetsuro
T
Miki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism; D008875:Middle Aged; D016017:Odds Ratio; D012306:Risk; D012307:Risk Factors