Obesity, independent of insulin resistance, is a major determinant of blood pressure in normoglycemic Hong Kong Chinese

Obesity and insulin resistance are considered important links underlying th e development of hypertension. In Caucasians, there have been many reports of an association between insulin resistance and hypertension. However, thi s relationship is not consistently found in other ethnic groups. In this st udy, we examined the involvement of insulin resistance (assessed as fasting insulin-glucose product, FIGP) and general and central obesity as potentia l links in the development of hypertension in 413 normoglycemic Hong Kong C hinese (56.9% hypertensive) subjects. Anthropometric parameters (waist circ umference [WC], waist-to-hip ratio [WHR], body mass index [BMI]), surrogate measures of insulin resistance (fasting plasma glucose, insulin, FIGP), fa sting lipids and systolic (SBP) and diastolic (DBP) blood pressure were mea sured. Both male and female hypertensives were more obese and dyslipidemic, and the fem ales had higher indices of insulin resistance than the normote nsive subjects of the same gender. Before adjustment for age, gender, and a diposity, FIGP correlated with SEP in the total (r = .19, P = .009) and low BMI (r = .23, P < .05) and low WHR (r = .25, P < .01) groups. However, aft er adjustment, there was no significant relationship between FIGP and blood pressure. In contrast, BMI and WC were strongly associated with blood pres sure (r greater than or equal to .41, P < .001 for both DBP and SEP in the total population), although in the group with general obesity, the strength of the relationship was weaker (r <greater than or equal to> .13). These r elationships persisted after adjustment for age, gender, and FIGP. Obesity, therefore, appears to have a predominant role compared with insulin resist ance in determining blood pressure in these normoglycemic Chinese. Copyrigh t (C) 2000 by W.B. Saunders Company.