Insulin Resistance and Prevalence of Prehypertension and Hypertension Among Community-Dwelling Persons

抄録

Aim: There are few data focusing on the effect of insulin resistance on a new risk category of prehy-pertension (120-139 mmHg systolic and/or 80-89 mmHg diastolic blood pressure) recently estab-lished 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 devia-tion); 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 hyper-tension 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 hyperten-sion in the general population.