title: Five-year weight changes associate with blood pressure alterations independent of changes in serum insulin.
abstract: OBJECTIVE
  In overweight-related hypertension, the effect of weight changes on blood pressure (BP) is believed to be mediated by insulin. To test this hypothesis, we studied 5-year changes in weight, BP, and insulin in a general population of Danish adults (n = 3443; mean age 45.7 ± 7.6 years).
  
  
  METHODS
  We assessed the glucose-insulin metabolism by a standard oral glucose tolerance test. We divided the antihypertensive and antidiabetic medication-free participants into three groups: weight loss (n = 515), weight stable (n = 1778), and weight gain (n = 1150).
  
  
  RESULTS
  Losing on average 6.5 kg body weight, the weight loss group experienced a 28.2% reduction [(95% confidence interval [CI] -31 to -25); P < 0.001] in fasting insulin and a 23.9% reduction [(95% CI -28 to -19); P < 0.001] in 2-h insulin. Gaining on average 6.4 kg, the weight gain group experienced a 12.5% increase [(95% CI 9 to 16); P < 0.001] in fasting insulin and 32.8% increase [(95% CI 28 to 38); P < 0.001] in 2-h insulin. Using linear regression adjusting for differences in sex, age, family history of hypertension, baseline BMI, SBP and DBP, lifestyle risk factors, and their 5-year changes, weight loss was associated with a decrease in SBP of -1.8 mmHg (95% CI -2.8 to -0.7), whereas weight gain with an increase in SBP of 1.9 mmHg (95% CI 1.2 to 2.6), both with P less than 0.001. Adding fasting insulin, 2-h insulin, Δfasting insulin, and Δ2-h insulin only marginally attenuated the association, and furthermore, none of the insulin variables was significantly associated with SBP or DBP (P ≥ 0.08). The results for changes in DBP were similar to SBP.
  
  
  CONCLUSIONS
  Five-year weight changes associate with BP alterations independent of the insulin changes.
authors.affiliation: aCardiovascular Research Unit, Department of Internal Medicine, Copenhagen University Hospital Glostrup bResearch Centre for Prevention and Health, Copenhagen University Hospital Glostrup, Glostrup cFaculty of Health Sciences, University of Copenhagen, Copenhagen dDepartment of Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark.
authors.forename: Ekim
authors.initials: E
authors.lastname: Seven
authors.forename: Lise L N
authors.initials: LL
authors.lastname: Husemoen
authors.forename: Kristian
authors.initials: K
authors.lastname: Wachtell
authors.forename: Hans
authors.initials: H
authors.lastname: Ibsen
authors.forename: Allan
authors.initials: A
authors.lastname: Linneberg
authors.forename: Jørgen L
authors.initials: JL
authors.lastname: Jeppesen
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001795:Blood Pressure Determination; D001835:Body Weight; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D007328:Insulin