title: Impact of hyperinsulinemia on the development of hypertension in normotensive, nondiabetic adults: a 4-year follow-up study.
abstract: OBJECTIVE
  This study aimed to investigate the association between baseline fasting insulin levels, changes in fasting insulin levels, and future development of hypertension in normotensive, non-diabetic, healthy adults.
  
  
  METHODS
  We analyzed data from 11,123 adults, aged 20-65years, who had no history of hypertension or diabetes mellitus at a 2004 medical examination in a health promotion program and had attended a repeat examination in 2008. Subjects were divided into four groups according to baseline quartiles of fasting insulin and dichotomized fasting insulin levels at baseline and after 4years: low-low, low-high, high-low, high-high. We also assessed whether the association differed between the younger (20-40years) and older subjects (41-65years).
  
  
  RESULTS
  In four years, 1142 subjects (10.3%) developed hypertension. The odds ratio (OR) for the development for hypertension increased as the quartiles of baseline fasting insulin levels and changes in fasting insulin levels increased from the first to the fourth quartile (OR 1.15, 1.35, and 1.95 vs. 1.07, 1.22, and 1.41, respectively), after adjusting for multiple factors. The OR for hypertension was 2.0-fold higher in the high-high group and 1.34-fold higher in the low-high group than in the low-low group. In comparing the results by age group, we found that these relationships were more prominent in younger subjects.
  
  
  CONCLUSIONS
  High baseline and continuously increasing fasting insulin levels appeared to be independent determinants for the future development of hypertension during this 4-year follow-up study in normotensive, non-diabetic, healthy adults.
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Se Eun
authors.initials: SE
authors.lastname: Park
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Rhee
authors.forename: Cheol-Young
authors.initials: CY
authors.lastname: Park
authors.forename: Ki Won
authors.initials: KW
authors.lastname: Oh
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Sun-Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D000886:Anthropometry; D044466:Asian People; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications*; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D055815:Young Adult
chemical_list: D007328:Insulin; D008055:Lipids