Abstract 10957: Association of Insulin Resistance and Dysglycemia With Components of Blood Pressure: A Study From the Hispanic Community Health Study/Study of Latinos

Abstract

Background: Data are conflicting regarding the extent to which insulin resistance or dysglycemia contribute to the development of elevated blood pressure (BP). Therefore, we examined whether these metabolic abnormalities are associated with distinct BP components, including measures of pulsatile versus steady state load (surrogates for large and small artery disease) in a large community-based cohort. Methods: We studied 10,720 non-diabetic participants from 4 U.S. sites in the Hispanic Community Health Study / Study of Latinos who were free of cardiovascular disease and not on any anti-hypertensive medications. We used linear regression for complex survey sampling and non-parametric spline models to examine the relation of insulin resistance (HOMA-IR) and dysglycemia (HbA1c) with components of BP (systolic, diastolic, pulse pressure [PP, reflecting pulsatile load], and mean arterial pressure [MAP, reflecting steady state load]) while adjusting for established clinical correlates of BP. Results: The target population mean age was 38 years (s.e. 0.22) and included 52% women, 38% with pre-diabetes, 35% obese, and 9% with untreated hypertension. All BP component measures were higher in pre-diabetes than non-diabetes. In multivariable analyses, HOMA-IR was significantly associated with increase in all BP components (P<0.01 for all), including both PP and MAP, in the setting of both pre-diabetes and particularly non-diabetes (Figure). By contrast, HbA1c was not significantly associated with increase in any BP component. Conclusion: In a large population of non-diabetic Hispanic/Latino adults, insulin resistance (rather than dysglycemia per se) is related to increase in all BP components including measures of both pulsatile load (representing large artery disease) and steady state load (representing small artery disease). These findings may have implications for interventions aimed at preventing large and small vessel disease in the community.