Abstract
We sought to determine whether insulin resistance (IR) is related to arterial stiffness in nondiabetic hypertensive patients, independent of metabolic status and gender. IR has been associated with increased arterial stiffness in patients with diabetes. In nondiabetic hypertensive patients, the correlation between IR and arterial stiffness has yet to be investigated. We enrolled 284 nondiabetic patients who were being treated for hypertension. At the time of enrollment, the patients underwent a baseline laboratory assessment including homeostatic model assessment (HOMA) IR index and pulse wave velocity (PWV). The HOMA IR index is used as a marker of IR, and brachial to ankle PWV (baPWV) was used as a marker of arterial stiffness. Of the 284 study subjects, 121 were classified as having metabolic syndrome. The patients with metabolic syndrome were older than the non-metabolic syndrome patients (55.4±10.7 vs. 52.1±11.6 years, p=0.013), but there was no gender difference between the two groups. The average baPWV was significantly higher in the patients with metabolic syndrome (1,506±235 vs. 1,435±211 cm/s, p=0.009). The HOMA index was independently associated with an increase in arterial stiffness (r=0.548, p<0.001) after controlling for age, systolic blood pressure (SBP), heart rate, medication and gender. The independent association of HOMA with arterial stiffness was demonstrated in subgroup analysis, regardless of the metabolic status and gender. In conclusion, increased IR was associated with arterial stiffness, independent of age, baseline SBP, gender and heart rate. This independent association of IR was demonstrated regardless of gender and metabolic status.
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Franklin SS, Gustin W 4th, Wong ND, et al: Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997; 96: 308–315.
Laurent S, Katsahian S, Fassot C, et al: Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke 2003; 34: 1203–1206.
Domanski MJ, Mitchell GF, Norman JE, Exner DV, Pitt B, Pfeffer MA : Independent prognostic information provided by sphygmomanometrically determined pulse pressure and mean arterial pressure in patients with left ventricular dysfunction. J Am Coll Cardiol 1999; 33: 951–958.
Yambe M, Tomiyama H, Hirayama Y, et al: Arterial stiffening as a possible risk factor for both atherosclerosis and diastolic heart failure. Hypertens Res 2004; 27: 625–631.
Seals DR, Tanaka H, Clevenger CM, et al: Blood pressure reductions with exercise and sodium restriction in postmenopausal women with elevated systolic pressure: role of arterial stiffness. J Am Coll Cardiol 2001; 38: 506–513.
Sullivan JM, Prewitt RL, Josephs JA : Attenuation of the microcirculation in young patients with high-output borderline hypertension. Hypertension 1983; 5: 844–851.
Isaksson H, Cederholm T, Jansson E, Nygren A, Ostergren J : Therapy-resistant hypertension associated with central obesity, insulin resistance, and large muscle fibre area. Blood Press 1993; 2: 46–52.
Julius S, Gudbrandsson T, Jamerson K, Andersson O : The interconnection between sympathetics, microcirculation, and insulin resistance in hypertension. Blood Press 1992; 1: 9–19.
Hirose H, Saito I, Kawabe H, Saruta T : Insulin resistance and hypertension: seven-year follow-up study in middle-aged Japanese men (the KEIO study). Hypertens Res 2003; 26: 795–800.
Sarafidis PA, Lasaridis AN, Nilsson PM, et al: Ambulatory blood pressure reduction after rosiglitazone treatment in patients with type 2 diabetes and hypertension correlates with insulin sensitivity increase. J Hypertens 2004; 22: 1769–1777.
Reaven GM, Lithell H, Landsberg L : Hypertension and associated metabolic abnormalities—the role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996; 334: 374–381.
Safar ME : Systolic hypertension in the elderly: arterial wall mechanical properties and the renin-angiotensin-aldosterone system. J Hypertens 2005; 23: 673–681.
Salomaa V, Riley W, Kark JD, Nardo C, Folsom AR : Non-insulin dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes—the ARIC Study. Circulation 1995; 91: 1432–1443.
Scuteri A, Najjar SS, Muller DC, et al: Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness. J Am Coll Cardiol 2004; 43: 1388–1395.
van Popele NM, Westendorp IC, Bots ML, et al: Variables of the insulin resistance syndrome are associated with reduced arterial distensibility in healthy non-diabetic middle-aged women. Diabetologia 2000; 43: 665–672.
van Dijk RA, Bakker SJ, Scheffer PG, Heine RJ, Stehouwer CD : Associations of metabolic variables with arterial stiffness in type 2 diabetes mellitus: focus on insulin sensitivity and postprandial triglyceridaemia. Eur J Clin Invest 2003; 33: 307–315.
The National Cholesterol Education Program (NCEP) Expert Panel : Executive summary of the third report of The National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults, Adult Treatment Panel III. JAMA 2001; 285: 2486–2497.
Ford ES, Gilés WH, Dietz WH : Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356–359.
Choi KM, Lee KW, Seo JA, et al: Relationship between brachial-ankle pulse wave velocity and cardiovascular risk factors of the metabolic syndrome. Diabetes Res Clin Pract 2004; 66: 57–61.
Koizumi M, Shimizu H, Shimomura K, et al: Relationship between hyperinsulinemia and pulse wave velocity in moderately hyperglycemic patients. Diabetes Res Clin Pract 2003; 62: 17–21.
Kubo T, Miyata M, Minagoe S, Setoyama S, Maruyama I, Tei C : A simple oscillometric technique for determining new indices of arterial distensibility. Hypertens Res 2002; 25: 351–358.
Yamashina A, Tomiyama H, Takeda K, et al: Validity, reproducibility, and clinical significance of noinvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002; 25: 359–364.
Kostis J, Lawrence-Nelson J, Ranjan R, Wilson AC, Kostis WJ, Lacy CR : Association of increased pulse pressure with the development of heart failure in SHEP. Systolic Hypertension in the Elderly (SHEP) Cooperative Research Group. Am J Hypertens 2001; 14: 798–803.
Safar ME, Levy BI, Struijker-Boudier H : Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003; 107: 2864–2869.
Emoto M, Nishizawa Y, Kawagishi T, et al: Stiffness indexes beta of the common carotid and femoral arteries are associated with insulin resistance in NIDDM. Diabetes Care 1998; 21: 1178–1182.
Deepa R, Pradeepa R, Shanthirani CS, Mohan V : Chennai Urban Population Study (CUPS-12): association of hypertension with cluster of insulin resistance syndrome factors. Acta Diabetol 2004; 41: 49–55.
Westerbacka J, Seppala-Lindroos A, Yki-Jarvinen H : Resistance to acute insulin induced decreases in large artery stiffness accompanies the insulin resistance syndrome. J Clin Endocrinol Metab 2001; 86: 5262–5268.
Sandqvist M, Nyberg G, Hammarstedt A, et al: Low adipocyte IRS-1 protein expression is associated with an increased arterial stiffness in non-diabetic males. Atherosclerosis 2005; 180: 119–125.
Raji A, Seely EW, Bekins SA, Williams GH, Simonson DC : Rosiglitazone improves insulin sensitivity and lowers blood pressure in hypertensive patients. Diabetes Care 2003; 26: 172–178.
O'Rourke MF, Hayward CS : Arterial stiffness, gender and heart rate. J Hypertens 2003; 21: 487–490.
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Seo, HS., Kang, T., Park, S. et al. Insulin Resistance Is Associated with Arterial Stiffness in Nondiabetic Hypertensives Independent of Metabolic Status. Hypertens Res 28, 945–951 (2005). https://doi.org/10.1291/hypres.28.945
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DOI: https://doi.org/10.1291/hypres.28.945
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