HYPERINSULINEMIA IS ASSOCIATED WITH THE INCIDENCE OF HYPERTENSION ANDDYSLIPIDEMIA IN MIDDLE-AGED MEN

Insulin resistance or compensatory hyperinsulinemia has been associate d with hypertension and dyslipidemia in cross-sectional studies, In co ntrast, evidence from prospective population-based studies, which coul d establish the time order of the relationship, Is sparse and inconsis tent, Therefore, we investigated the associations of hyperinsulinemia with the incidence of hypertension and dyslipidemia In the Kuopio Isch emic Heart Disease Risk Factor Study, a population-based 4-year follow -up study of middle-aged men from eastern Finland, Out of 975 men who had no diabetes, 543 had resting systolic blood pressure (sBP) of <165 mmHg and resting diastolic blood pressure (dBP) of <95 mmHg at baseli ne and were not taking antihypertensive medication, and 764 had serum triglycerides of <2.3 mmol/l and HDL cholesterol of greater than or eq ual to 1.0 mmol/l at baseline, In logistic regression models adjusted for age, baseline resting blood pressure, baseline lipids, obesity, we ight change, and ether risk factors, men with hyperinsulinemia (fastin g insulin in the highest quintile, greater than or equal to 12.0 mU/l) at baseline had a 2.0-fold (95% CI 1.1-3.5, P = 0.025) incidence of h ypertension (sBP of greater than or equal to 165 or dBP of greater tha n or equal to 95 mmHg), a 2.1-fold (95% CI 1.3-3.4, P = 0.002) inciden ce of dyslipidemia (serum HDL cholesterol of <1.0 mmol/l or serum trig lycerides of greater than or equal to 2.3 mmol/l), and a 2.6-fold (95% CI 1.1-6.3, P = 0.028) incidence of the combination of these disorder s in 4 years, compared with normoinsulinemic men, These findings demon strate the role of hyperinsulinemia in incident hypertension and dysli pidemia and suggest that both hypertension and dyslipidemia are associ ated with insulin metabolism disturbance, independently of obesity and body weight.