Elevated fasting serum insulin level predicts future development of hypertension.
BACKGROUND
Studies have investigated clinical association between fasting insulin level and hypertension. However, it is still debatable whether elevated fasting insulin actually increases the risk of hypertension with the passage of time. Thus, this study was aimed at investigating the association between baseline fasting insulin level and the development of hypertension.


METHODS
25,062 normotensive, non-diabetic Korean men participating in a medical health check-up program were followed up from 2005 until 2010. They were divided into 4 groups according to baseline fasting insulin levels (first quartile-fourth quartile). The incidence of hypertension was compared among 4 groups, and Cox proportional hazards model was used to determine if hypertension was associated with higher baseline fasting insulin level.


RESULTS
The incidence of hypertension increased according to the baseline fasting insulin level (first quartile: 13.3%, second quartile: 15.4%, third quartile: 17.5%, fourth quartile: 23.2%, P<0.001). Even after adjusting for multiple covariates, the HRs (95% CI) for hypertension were higher for the second (1.12; 0.96-1.31), third (1.39; 1.20-1.62) and fourth quartile group (1.75; 1.51-2.03), compared to the first quartile group, respectively (P for trend<0.001).


CONCLUSIONS
The risk of hypertension was in proportion to the baseline fasting insulin level. In addition, hyperinsulinemia was an independent risk factor for the future development of hypertension. These findings suggest the value of fasting insulin level as an early predictor of hypertension.
Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Sung Keun
SK
Park
Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Ju Young
JY
Jung
Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
Won Joon
WJ
Choi
Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
Yun Hong
YH
Kim
Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
Hyun Soo
HS
Kim
Department of Physical Education, Graduate School, Sangji University, Wonju, Republic of Korea.
Woo Taek
WT
Ham
Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Hocheol
H
Shin
Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address: armani131@naver.com.
Jae-Hong
JH
Ryoo
D000328:Adult; D005215:Fasting / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D007328:Insulin / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
D007328:Insulin
Blood pressure; Hypertension; Insulin