HYPERINSULINEMIA AND CLUSTERING OF CARDIOVASCULAR RISK-FACTORS IN MIDDLE-AGED HYPERTENSIVE FINNISH MEN AND WOMEN

Objective To examine the relationship between hyperinsulinemia and clu sters of cardiovascular risk factors in middle-aged hypertensive patie nts, Design A population-based study. Setting Pieksamaki District Heal th Center, and the Community Health Center of the city of Tampere, in central Finland, Subjects Hypertensive men and women aged 36, 41, 46, and 51 years (n = 161) in the town of Pieksamaki, and a normotensive c ontrol population of 177 subjects aged 40 and 45 years in the city of Tampere, Main outcome measures Clusters of obesity (body mass index > 30.0 kg/m(2)), abdominal adiposity (waist:hip ratio > 1.00 for men and > 0.88 for women), hypertriglyceridemia (> 1.70 mmol/l), a low level of high-density lipoprotein cholesterol (< 1.0 mmol/l in men and < 1.2 0 mmol/l in women) and abnormal glucose metabolism (impaired glucose t olerance or noninsulin-dependent diabetes as defined by World Health O rganization criteria) according to statistical quartiles of the fastin g plasma insulin concentration, Results Among the hypertensives, there was a 2.0- to 3.6-fold higher risk of having a clustering of the insu lin-resistance associated cardiovascular risk factors compared with th at of the normotensives. Among the hypertensive subjects in the highes t quartile of fasting plasma insulin there was a six- to 12-fold incre ase in risk associated with having two or more insulin resistance-asso ciated cardiovascular risk factors compared with the subjects in the l owest quartile, There was a positive correlation between a high number of ascertained risk factors and high levels of fasting plasma insulin , Conclusion In clinical practice, knowledge of the close relationship between risk-factor cluster status and fasting plasma insulin levels offers a tool to evaluate the occurrence of hyperinsulinemia in middle -aged hypertensive men and women.