title: Euglycemic clamp insulin sensitivity and longitudinal systolic blood pressure: role of sex.
abstract: Insulin resistance may be an independent risk factor for the development of hypertension, but change in blood pressure (BP) over time has not been adequately studied in healthy individuals fully characterized for insulin sensitivity. In the Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) study, we measured insulin sensitivity (M/I) using the euglycemic clamp technique in 1073 healthy European adults (587 women, 486 men) aged 30 to 60 years followed up 3 years later. Systolic BP (SBP) at baseline was higher in insulin-resistant women (ie, those in the low sex-specific M/I tertile) compared with those in the intermediate (P<0.001) or high tertiles (P=0.06; mean ± SD: 117 ± 13, 111 ± 12, 114 ± 12 mm Hg, respectively). It did not differ across M/I tertiles in men. After adjustment for age, body mass index, baseline SBP, and other covariates, low insulin sensitivity (M/I) predicted a longitudinal rise in SBP in women but not in men; M/I was not associated with change in diastolic BP. SBP rose over time in both sexes and within all M/I tertiles (P<0.05), except in women with high insulin sensitivity. Therefore, in women (but not in men), low insulin sensitivity was associated with higher SBP at 3 years, and high insulin sensitivity was associated with a lower rise in SBP over time.
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, United Kingdom. john.petrie@glasgow.ac.uk
authors.forename: John R
authors.initials: JR
authors.lastname: Petrie
authors.forename: Muhammad Omar
authors.initials: MO
authors.lastname: Malik
authors.forename: Beverley
authors.initials: B
authors.lastname: Balkau
authors.forename: Colin G
authors.initials: CG
authors.lastname: Perry
authors.forename: Kurt
authors.initials: K
authors.lastname: Højlund
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Pataky
authors.forename: John
authors.initials: J
authors.lastname: Nolan
authors.forename: Ele
authors.initials: E
authors.lastname: Ferrannini
authors.forename: Andrea
authors.initials: A
authors.lastname: Natali
mesh_terms: D000328:Adult; D001794:Blood Pressure; D005260:Female; D015309:Glucose Clamp Technique / Q000379:methods*; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
keywords: blood pressure; hypertension; insulin; insulin resistance; sex