PATTERNS AND PREDICTORS OF HYPERTENSION INCIDENCE AMONG HISPANICS ANDNON-HISPANIC WHITES - THE SAN-LUIS VALLEY DIABETES STUDY

Objectives: To determine whether Hispanics are at lower risk for the d evelopment of hypertension than non-Hispanic Whites. We also examined selected predictors of hypertension incidence and explored the role of markers of insulin resistance in the development of hypertension. Des ign: A cohort study of a geographically-based sample of Hispanic and n on-Hispanic white southern Colorado residents who were re-examined an average of 4 years after their baseline examination. Methods: These an alyses included 664 participants who were normotensive and confirmed n ondiabetic by an oral glucose tolerance test at their baseline examina tion. Hypertension was defined as systolic blood pressure greater than or equal to 140 mmHg or diastolic blood pressure greater than or equa l to 90 mmHg or use of antihypertensive medication. Results: Hispanics and non-Hispanic Whites had similar hypertension incidence rates. The strongest predictors of hypertension incidence were baseline blood pr essure and age. Higher baseline heart rates and higher body mass index also predicted hypertension. Increased fasting insulin levels were as sociated with hypertension incidence among lean participants, though t he association disappeared once baseline blood pressure levels were ad ded to the models. Models investigating change in systolic or diastoli c blood pressure levels found higher baseline levels of insulin area u nder the glucose tolerance curve predicted greater increases in systol ic blood pressure in non-Hispanic Whites only. Conclusions: Hypertensi on incidence rates were similar in Hispanics and non-Hispanic Whites. Higher levels of insulin area were associated with larger increases in systolic blood pressure among non-Hispanic Whites only.