HYPERTENSION, HYPERINSULINEMIA AND OBESITY IN MIDDLE-AGED FINNS WITH IMPAIRED GLUCOSE-TOLERANCE

The aim of the study was to analyse the data obtained from a 2-year fo llow-up study of middle-aged Finnish subjects (n = 183) with a previou s history of impaired glucose tolerance (IGT) in order to elucidate th e longitudinal relationships between hypertension, fasting hyperinsuli naemia and obesity. Hypertension was defined as either a systolic bloo d pressure (BP) of greater than or equal to 160 mm Hg or a diastolic B P of greater than or equal to 95 mm Hg or being on antihypertensive me dication regardless of the BP value. Multiple logistic regression anal ysis adjusted for glucose tolerance status, serum lipids, exercise beh aviour and alcohol consumption shows that the odds ratios of one unit (mU/I) increase in the baseline fasting insulin concentration were 1.1 3 (95% confidence interval 1.00-1.28) for the 2-year incidence of hype rtension in subjects with IGT at baseline, Baseline body mass index (B MI) also predicted the 5-year incidence of hypertension, with an odds ratio of 1.20 (95% CI 1.02-1.42). BMI correlated positively with fasti ng insulin level (r = 0.54, P < 0.001), It is concluded that an elevat ed fasting insulin concentration as well as an increased BMI preceded the onset of hypertension in subjects with IGT, It may suggest a causa l relationship between hypertension and hyperinsulinaemia.