Euglycemic Clamp Insulin Sensitivity and Longitudinal Systolic Blood Pressure

Author:

Petrie John R.1,Malik Muhammad Omar1,Balkau Beverley1,Perry Colin G.1,Højlund Kurt1,Pataky Zoltan1,Nolan John1,Ferrannini Ele1,Natali Andrea1

Affiliation:

1. From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)

Abstract

Insulin resistance may be an independent risk factor for the development of hypertension, but change in blood pressure (BP) over time has not been adequately studied in healthy individuals fully characterized for insulin sensitivity. In the Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) study, we measured insulin sensitivity (M/I) using the euglycemic clamp technique in 1073 healthy European adults (587 women, 486 men) aged 30 to 60 years followed up 3 years later. Systolic BP (SBP) at baseline was higher in insulin-resistant women (ie, those in the low sex-specific M/I tertile) compared with those in the intermediate ( P <0.001) or high tertiles ( P =0.06; mean±SD: 117±13, 111±12, 114±12 mm Hg, respectively). It did not differ across M/I tertiles in men. After adjustment for age, body mass index, baseline SBP, and other covariates, low insulin sensitivity (M/I) predicted a longitudinal rise in SBP in women but not in men; M/I was not associated with change in diastolic BP. SBP rose over time in both sexes and within all M/I tertiles ( P <0.05), except in women with high insulin sensitivity. Therefore, in women (but not in men), low insulin sensitivity was associated with higher SBP at 3 years, and high insulin sensitivity was associated with a lower rise in SBP over time.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Internal Medicine

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