Fasting insulin, insulin resistance and risk of hypertension in the general population: A meta-analysis.
BACKGROUND
Studies on the association of fasting insulin concentrations or insulin resistance with subsequent risk of hypertension have yielded conflicting results.


OBJECTIVE
To quantitatively assess the association of fasting insulin concentrations or homeostasis model assessment insulin resistance (HOMA-IR) with incident hypertension in a general population by performing a meta-analysis.


METHODS
We searched the PubMed and Embase databases until August 31, 2016 for prospective observational studies investigating the elevated fasting insulin concentrations or HOMA-IR with subsequent risk of hypertension in the general population. Pooled risk ratio (RR) and 95% confidence interval (CI) of hypertension was calculated for the highest versus the lowest category of fasting insulin or HOMA-IR.


RESULTS
Eleven studies involving 10,230 hypertension cases were identified from 55,059 participants. Meta-analysis showed that the pooled adjusted RR of hypertension was 1.54 (95% CI 1.34-1.76) for fasting insulin concentrations and 1.43 (95% CI 1.27-1.62) for HOMA-IR comparing the highest to the lowest category. Subgroup analysis results showed that the association of fasting insulin concentrations with subsequent risk of hypertension seemed more pronounced in women (RR 2.07; 95% CI 1.19-3.60) than in men (RR 1.48; 95% CI 1.17-1.88).


CONCLUSIONS
This meta-analysis suggests that elevated fasting insulin concentrations or insulin resistance as estimated by homeostasis model assessment is independently associated with an exacerbated risk of hypertension in the general population. Early intervention of hyperinsulinemia or insulin resistance may help clinicians to identify the high risk of hypertensive population.
Department of Cardiology, The Frist Affiliated Hospital of Chongqing Medical University, Chongqing, China, 400016.
Feng
F
Wang
Department of Emergency, Zoucheng People's Hospital, Zoucheng, Shandong Province, China, 273500.
Lili
L
Han
Department of Cardiology, The Frist Affiliated Hospital of Chongqing Medical University, Chongqing, China, 400016. Electronic address: hudayicq01@163.com.
Dayi
D
Hu
D005215:Fasting / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000378:metabolism* / Q000503:physiopathology; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D012306:Risk
D007328:Insulin
Fasting insulin; HOMA-IR; Hypertension; Insulin resistance; Meta-analysis