Among African Americans without baseline hypertension, the highest quartile of HOMA-IR was associated with a greater risk of blood pressure progression (RR 1.25; 95% CI 1.09-1.43) over 7 years.
Cohort (n=1,064)
Does higher insulin resistance increase the risk of blood pressure progression and incident hypertension in African Americans without baseline hypertension?
Higher insulin resistance and metabolic syndrome are significantly associated with an increased risk of blood pressure progression and incident hypertension among African Americans.
Effect estimate: RR 1.25 (95% CI 1.09-1.43)
p-value: p=0.004
OBJECTIVE: There is a paucity of data on the relations of insulin resistance with incident blood pressure (BP) changes among Blacks. We investigated the associations of insulin resistance and metabolic syndrome (MetS) with BP progression in a community-based sample of African Americans. METHODS: We analyzed 1064 participants without hypertension at baseline (2000-2004) who attended at least one follow-up visit in 2005-2008 or 2009-2013. Four insulin resistance indices fasting insulin, insulin-to-glucose ratio (IGR), homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) and MetS (excluding hypertension in the definition) were assessed at baseline. Robust Poisson regression was used to generate risk ratios (RRs) and 95% confidence intervals (CI) for BP progression and incident hypertension. RESULTS: Over a median of 7 years, 69.6% progressed to a higher BP category and 62.7% developed hypertension. After multivariable adjustment, participants in the highest quartile of HOMA-IR had higher risks of BP progression RR 1.25 (95% CI 1.09-1.43), Ptrend = 0.004 and hypertension RR 1.35 (95% CI 1.16-1.58), Ptrend < 0.001 compared with those in the lowest quartile. A similar positive association of insulin resistance with BP outcomes was noted with insulin resistance assessed using IGR, fasting insulin, and QUICKI. MetS was associated with increased risks of BP progression RR 1.15 (95% CI 1.02-1.30), P = 0.02 and incident hypertension RR 1.23 [95% CI 1.08-1.41, P = 0.002]. These associations were present across baseline BP categories. CONCLUSION: Our findings support the notion that higher insulin resistance levels are associated with greater risks of BP progression and incident hypertension among Blacks.
Kazé et al. (Wed,) conducted a cohort in Blood pressure progression and incident hypertension (n=1,064). Highest quartile of HOMA-IR vs. Lowest quartile of HOMA-IR was evaluated on Blood pressure progression (RR 1.25, 95% CI 1.09-1.43, p=0.004). Among African Americans without baseline hypertension, the highest quartile of HOMA-IR was associated with a greater risk of blood pressure progression (RR 1.25; 95% CI 1.09-1.43) over 7 years.
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