title: Relatively lower central aortic pressure in patients with impaired insulin sensitivity and resistance: the Toon Health Study.
abstract: OBJECTIVE
  Central aortic blood pressure (BP) has been postulated to correlate more closely with cardiovascular disease risk than brachial cuff BP. However, the effect of insulin sensitivity and resistance on central BP is not fully understood. Here, we evaluated the associations between insulin sensitivity/resistance and central BP using the oral glucose tolerance test.
  
  
  METHODS
  A total of 1034 Japanese participants were enrolled in this study. The absolute pressure of the late systolic peak (SBP2) of the brachial BP obtained by the radial waveform was considered to be the central systolic BP. Oral glucose tolerance test was performed by administering 75 g of glucose, and blood samples were obtained at 0, 60, 120 min after glucose loading.
  
  
  RESULTS
  Mean SBP2 was found to be lower than mean brachial systolic BP (SBP) (119 ± 20, 126 ± 19 mmHg, P < 0.001), and differences between SBP and SBP2 were significantly larger in patients with reduced insulin sensitivity (-8.2 ± 5.2, -7.2 ± 5.3, -7.1 ± 5.1, and -6.5 ± 4.9 mmHg, in the first, second, third and fourth quartiles, respectively; P = 0.002) and increased insulin resistance (-6.6 ± 5.1, -6.6 ± 4.8, -7.3 ± 4.8, -8.5 ± 5.6 mmHg, P < 0.001). Multiple linear regression analysis identified reduced insulin sensitivity (β = 0.067, P = 0.033) and increased insulin resistance (β = -0.081, P = 0.009) as independent determinants of the difference between SBP and SBP2.
  
  
  CONCLUSIONS
  Given that both insulin sensitivity and insulin resistance were found to be significant determinants of the difference between SBP and SBP2 in a healthy general population, we suggest measuring the SBP2 in individuals with impaired insulin action in order to accurately assess their risk of developing cardiovascular disease.
authors: Department of Basic Medical Research and Education, Ehime University Proteo-Medicine Research Center, Ehime, Japan. tabara@m.ehime-u.ac.jp
authors: Yasuharu
authors: Y
authors: Tabara
authors: Isao
authors: I
authors: Saito
authors: Wataru
authors: W
authors: Nishida
authors: Katsuhiko
authors: K
authors: Kohara
authors: Susumu
authors: S
authors: Sakurai
authors: Ryoichi
authors: R
authors: Kawamura
authors: Hiroshi
authors: H
authors: Onuma
authors: Yasunori
authors: Y
authors: Takata
authors: Haruhiko
authors: H
authors: Osawa
authors: Tetsuro
authors: T
authors: Miki
authors: Takeshi
authors: T
authors: Tanigawa
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology*; D007564:Japan; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013599:Systole; D059289:Vascular Stiffness / Q000502:physiology