Five-year weight changes associate with blood pressure alterations independent of changes in serum insulin

TY - JOUR

T1 - Five-year weight changes associate with blood pressure alterations independent of changes in serum insulin

AU - Seven, Ekim

AU - Husemoen, Lise L N

AU - Wachtell, Kristian

AU - Ibsen, Hans

AU - Linneberg, Allan

AU - Jeppesen, Jørgen L

PY - 2014/11

Y1 - 2014/11

N2 - Objective: In overweight-related hypertension, the effect of weight changes on blood pressure (BP) is believed to be mediated by insulin. To test this hypothesis, we studied 5-year changes in weight, BP, and insulin in a general population of Danish adults (n=3443; mean age 45.7±7.6 years). Methods: We assessed the glucose-insulin metabolism by a standard oral glucose tolerance test. We divided the antihypertensive and antidiabetic medication-free participants into three groups: weight loss (n=515), weight stable (n=1778), and weight gain (n=1150). Results: Losing on average 6.5 kg body weight, the weight loss group experienced a 28.2% reduction [(95% confidence interval [CI]-31 to <25); P<0.001] in fasting insulin and a 23.9% reduction [(95% CI-28 to-19); P<0.001] in 2-h insulin. Gaining on average 6.4 kg, the weight gain group experienced a 12.5% increase [(95% CI 9 to 16); P<0.001] in fasting insulin and 32.8% increase [(95% CI 28 to 38); P<0.001] in 2-h insulin. Using linear regression adjusting for differences in sex, age, family history of hypertension, baseline BMI, SBP and DBP, lifestyle risk factors, and their 5-year changes, weight loss was associated with a decrease in SBP of-1.8mmHg (95% CI-2.8 to-0.7), whereas weight gain with an increase in SBP of 1.9mmHg (95% CI 1.2 to 2.6), both with P less than 0.001. Adding fasting insulin, 2-h insulin, Dfasting insulin, and δ2-h insulin only marginally attenuated the association, and furthermore, none of the insulin variables was significantly associated with SBP or DBP (P≥0.08). The results for changes in DBP were similar to SBP. Conclusion: Five-year weight changes associate with BP alterations independent of the insulin changes.

AB - Objective: In overweight-related hypertension, the effect of weight changes on blood pressure (BP) is believed to be mediated by insulin. To test this hypothesis, we studied 5-year changes in weight, BP, and insulin in a general population of Danish adults (n=3443; mean age 45.7±7.6 years). Methods: We assessed the glucose-insulin metabolism by a standard oral glucose tolerance test. We divided the antihypertensive and antidiabetic medication-free participants into three groups: weight loss (n=515), weight stable (n=1778), and weight gain (n=1150). Results: Losing on average 6.5 kg body weight, the weight loss group experienced a 28.2% reduction [(95% confidence interval [CI]-31 to <25); P<0.001] in fasting insulin and a 23.9% reduction [(95% CI-28 to-19); P<0.001] in 2-h insulin. Gaining on average 6.4 kg, the weight gain group experienced a 12.5% increase [(95% CI 9 to 16); P<0.001] in fasting insulin and 32.8% increase [(95% CI 28 to 38); P<0.001] in 2-h insulin. Using linear regression adjusting for differences in sex, age, family history of hypertension, baseline BMI, SBP and DBP, lifestyle risk factors, and their 5-year changes, weight loss was associated with a decrease in SBP of-1.8mmHg (95% CI-2.8 to-0.7), whereas weight gain with an increase in SBP of 1.9mmHg (95% CI 1.2 to 2.6), both with P less than 0.001. Adding fasting insulin, 2-h insulin, Dfasting insulin, and δ2-h insulin only marginally attenuated the association, and furthermore, none of the insulin variables was significantly associated with SBP or DBP (P≥0.08). The results for changes in DBP were similar to SBP. Conclusion: Five-year weight changes associate with BP alterations independent of the insulin changes.

U2 - 10.1097/hjh.0000000000000317

DO - 10.1097/hjh.0000000000000317

M3 - Journal article

C2 - 25275249

SN - 0263-6352

VL - 32

SP - 1

EP - 7

JO - Journal of Hypertension

JF - Journal of Hypertension

IS - 11

ER -