QJM Advance Access originally published online on August 7, 2009
QJM 2009 102(10):705-711; doi:10.1093/qjmed/hcp107
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Prehypertension is associated with insulin resistance
From the 1Section of Endocrinology and Metabolism, 2Faculty of Medicine, 3Section of General Medicine, Department of Medicine, Taipei Veterans General Hospital and 4Institute of Public Health, National Yang-Ming University School of Medicine, Taipei, Taiwan
Address correspondence to C.M. Hwu, MD, Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 201, Shih-Pai Rd. Sec. 2, Taipei 112, Taiwan. email: chhwu{at}vghtpe.gov.tw
Received 26 January 2009 and in revised form 27 June 2009
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Abstract |
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Background: Prehypertension, a new category of blood pressure (BP) classification introduced by The Seven Report of the Joint National Commission (JNC-7) on High BP for individuals with systolic BP in the range of 120–139 mmHg or diastolic BP between 80 and 89 mmHg, is a strong predictor for the development of hypertension. Insulin resistance (IR) has been proposed to be a key feature of metabolic abnormalities of hypertension and may precede the elevation of BP.
Aim: The purpose of the study is to evaluate whether prehypertension is associated with IR.
Design: This is a cross-sectional study.
Methods: Anthropometric and BP measurements were performed in 83 prehypertensive subjects and 192 normotensives. All subjects received a 75-g oral glucose tolerance test (OGTT) for the measurements of IR.
Results: The prehypertensive subjects were more obese and had higher levels of fasting triglycerides and 2-h insulin than the normotensives. The subjects with prehypertension were more insulin resistant than the counterparts, indicated by lower insulin sensitivity index, ISI0,120, values. While there was no difference between the two groups in insulin response of OGTT after adjustments for confounders, the prehypertension group maintained significant between-group differences in glucose response even when the incremental insulin levels were added to covariates for adjustments.
Discussion: Our data show that prehypertension is associated with IR. The subjects with prehypertension have clinical characteristics of the IR syndrome. It seems that the prehypertension group cannot handle oral glucose challenge as well as the normotension, probably a consequence of IR in prehypertension.