September 13, 2005Circulation
Relations of Insulin Sensitivity to Longitudinal Blood Pressure Tracking
Key result
Higher insulin sensitivity was associated with lower odds of hypertension incidence (OR 0.27; 95% CI 0.09-0.83; P<0.05) in younger individuals with normal BMI and baseline BP <130/85 mm Hg.
Why the study?
Does higher insulin sensitivity reduce the incidence of hypertension and blood pressure progression in nonhypertensive individuals?
Population
1933 nonhypertensive Framingham Study participants, median age 51 years, 56% women.
Comparison
Higher insulin sensitivity (second-to-fourth… vs Lowest quartile of insulin sensitivity
Design
Cohort
Follow-up
4 years
Authors
Discussion
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Implication
Does not yet warrant insulin sensitivity screening for hypertension prevention; leaves open causal role requiring prospective trials.
Study Design
Type
Cohort (n=1,933)
Structured PICO
Does higher insulin sensitivity reduce the incidence of hypertension and blood pressure progression in nonhypertensive individuals?
P
Population
1933 nonhypertensive Framingham Study participants, median age 51 years, 56% women.
I
Intervention
Higher insulin sensitivity (second-to-fourth quartiles of insulin sensitivity index, ISI(0,120))
C
Comparator
Lowest quartile of insulin sensitivity (most insulin resistant)
O
Outcome
4-year incidence of hypertension (systolic BP ≥140 or diastolic BP ≥90 mm Hg or antihypertensive medication use) and BP progression (≥1 BP stage increase)surrogate
Main Result
Effect estimate: OR 0.27 (95% CI 0.09 to 0.83)
p-value: p=<0.05
Reduced insulin sensitivity predicts blood pressure progression and hypertension incidence primarily in younger, normal-weight individuals with optimal baseline blood pressure.
Cite This Study
Ärnlöv et al. (2005) conducted a cohort in Nonhypertensive (n=1,933). Insulin sensitivity (ISI(0,120)) vs. Lowest quartile of insulin sensitivity was evaluated on 4-year incidence of hypertension (OR 0.27, 95% CI 0.09 to 0.83, p=<0.05). Higher insulin sensitivity was associated with lower odds of hypertension incidence (OR 0.27; 95% CI 0.09-0.83; P<0.05) in younger individuals with normal BMI and baseline BP <130/85 mm Hg.