Xun P et al. – Fasting serum insulin levels or hyperinsulinemia in young adulthood was positively associated with incidence of hypertension (HTN) later in life for both men and women, African Americans and Caucasians, and those with normal weight and overweight. The findings suggested that fasting insulin ascertainment may help clinicians identify those at high risk of HTN.Methods
- A prospective cohort of 3,413 Americans, aged 18–30 years, without HTN in 1985 (baseline) were enrolled.
- Six follow-ups were conducted in 1987, 1990, 1992, 1995, 2000, and 2005.
- Fasting insulin and glucose levels were assessed by a radioimmunoassay and hexokinase method, respectively.
- Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs of incident HTN (defined as the initiation of antihypertensive medication, systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg).
- During the 20-year follow-up, 796 incident cases were identified.
- After adjustment for potential confounders, participants in the highest quartile of insulin levels had a significantly higher incidence of HTN (HR 1.85 [95% CI 1.42–2.40]; Ptrend < 0.001) compared with those in the lowest quartile.
- The positive association persisted in each sex/ethnicity/weight status subgroup.
- A similar dose-response relation was observed when insulin-to-glucose ratio or homeostatic model assessment of insulin resistance was used as exposure.