Insulin resistance and prevalence of prehypertension and hypertension among community-dwelling persons

Abstract

Aim: There are few data focusing on the effect of insulin resistance on a new risk category of prehypertension (120-139 mmHg systolic and/or 80-89 mmHg diastolic blood pressure) recently established by The Seventh Report of the Joint National Committee on High Blood Pressure (JNC-7). We aimed to determine whether insulin resistance was associated with a risk for prehypertension and hypertension. Methods: Of 3,164 (34.6% of 9,133 adults aged 19 to 90 years) adults at the community-based annual medical check-up, study participants without a clinical history of stroke, transient ischemic attack, myocardial infarction, angina, or renal failure (567 men aged 57 ± 14 (mean ± standard deviation); range, 20-84) years and 702 women aged 59 ± 12; 21-88 years) were recruited. We examined the cross-sectional relationship between insulin resistance, which was evaluated by homeostasis of minimal assessment of insulin resistance (HOMA-IR) and normotension, prehypertension, or hypertension using the JNC-7 criteria. Results: The HOMA-IR correlated significantly with systolic (r = 0.171) and diastolic (r = 0.170) blood pressures. Triglycerides ≥ 150 mg/dL, HDL-C <40 mg/dL, metabolic syndrome, serum uric acid ≥ 7.0 mg/dL, and HOMA-IR ≥ 2.5 showed the highest crude odds ratio (OR) for progression from normotension to prehypertension, and ≥ 65 years, FBG ≥ 110 mg/dL, metabolic syndrome, and HOMA-IR ≥ 2.5 showed the highest crude OR for progression from normotension to hypertension. Multivariate logistic regression analysis showed that HOMA-IR was independently associated with the presence of prehypertension and hypertension. Conclusions: Insulin resistance was significantly associated with prehypertension as well as hypertension in the general population.