High blood pressure and insulin resistance: influence of ethnic background

E. FERRANNINI, S. M. HAFFNER, M. P. STERN, B. D. MITCHELL, A. NATALI, H. P. HAZUDA, J. K. PATTERSON

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Abstract. Hyperinsulinaemia links non‐insulin dependent diabetes (NIDDM), obesity, and hypertension, each an insulin‐resistant state in its own right. Insulin resistance predicts the occurrence of NIDDM, and plays a major role in its pathogenesis. We tested the hypothesis that hyperinsulinaemia may also predict hypertension in a sample (n= 2905) of the mixed population of San Antonio, in which hyperinsulinaemia and NIDDM are more prevalent among Mexican‐Americans than non‐Hispanic whites. Whilst in the whole sample the hypertensives had significantly (P < 0.001) higher plasma insulin concentrations than the normotensives, high blood pressure was significantly (P < 0.01) more frequent among non‐Hispanic whites than Mexican‐Americans regardless of diabetes status. After adjusting for factors (age, sex, body mass, and body fat distribution) known to affect insulin levels, a direct relationship between post‐glucose plasma insulin concentrations and prevalence of hypertension was still present in both ethnic groups. In Mexican‐Americans, however, the standardized prevalence of hypertension was significantly (P < 0.001) lower at any given insulin concentration. Post‐glucose plasma glucose levels also were directly related to hypertension prevalence in both groups; again, the regression line was shifted downward and, furthermore, less steep (P < 0.02) in Mexican‐Americans, suggesting relative protection against the negative effect of hyperglycaemia on blood pressure. Dyslipidaemia (higher total cholesterol and triglyceride, and lower HDL‐cholesterol concentrations) was strongly associated with hyperinsulinaemia and blood pressure in both ethnic groups. After adjusting for plasma insulin, only hypertriglyceridaemia was associated with high blood pressure, with no inter‐ethnic difference. We conclude that in this population hyperinsulinaemia is characteristic of hypertension but does not explain its prevalence against a divergent ethnic background. Other factors that determine high blood pressure must interact with insulin resistance to determine the prevalence rate of hypertension in the population.

Original languageEnglish (US)
Pages (from-to)280-287
Number of pages8
JournalEuropean Journal of Clinical Investigation
Volume21
Issue number3
DOIs
StatePublished - Jun 1991

Keywords

  • Ethnic differences
  • hyperinsulinaemia
  • hypertension
  • insulin resistance

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry

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