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.
Kawamoto
Ryuichi
R
Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan. rykawamo@ehime.med.or.jp
Kohara
Katsuhiko
K
Tabara
Yasuharu
Y
Abe
Masanori
M
Kusunoki
Tomo
T
Miki
Tetsuro
T
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