Hyperinsulinemia for the development of hypertension: Data from the Hawaii-Los Angeles-Hiroshima study

The present study was to assess the association of metabolic factors includ ing hyperinsulinemia, with the development of hypertension in Japanese-Amer icans. One hundred forty normotensive (< 140/90 mmHg) subjects aged 40 to 6 9 years old from the Hawaii-Los Angeles-Hiroshima study were followed for 1 5 years. Patients with cardiovascular disease were excluded. Body mass inde x (BMI), blood pressure (BP), serum total cholesterol (TC), tr[glycerides ( TG), uric acid (UA), and glucose and insulin responses at baseline, 1 h, an d 2 h after a glucose load were analyzed. Seventeen subjects became hyperte nsive (systolic BP greater than or equal to 160 mmHg, diastolic BP greater than or equal to 95 mmHg, or received drug treatment) during follow-up. Age - and sex-adjusted BMI, BP, serum UA, TG, insulin, and changes in fasting g lucose during follow-up were higher in subjects who later became hypertensi ve than in those who did not. There was no difference in the change in BMI. Age- and sex-adjusted relative risks for the development of hypertension b y quartiles of BMI, serum UA, TG, and the sum of insulin values (Sigma insu lin) during a glucose load were highest in highest quartile of the distribu tion. When age, sex, systolic BP, BMI, serum UA, TC, TG, fasting glucose, S igma insulin, and the change in BMI were used in a proportional hazard anal ysis, hyperinsulinemia, hyperuricemia, and systolic BP were found to be sig nificant risk factors for hypertension. In conclusion, hyperinsulinemia, as well as obesity, hyperuricemia, and hypertriglyceridemia were associated w ith hypertension in Japanese-Americans. Hyperinsulinemia and hyperuricemia were independent predictors of the development of hypertension.