Systolic and Diastolic Blood Pressures Correlate Better with Insulin Resistance than Pulse Blood Pressure in Nondiabetic Subjects
Abstract Number: 1004-P
Authors: CARLOS LORENZO, MANUEL SERRANO-RIOS, MARIA T. MARTINEZ-LARRAD, CLICERIO GONZALEZ-VILLALPANDO, KOKO AUNG, RAFAEL GABRIEL, MICHAEL P. STERN, STEVEN M. HAFFNER, San Antonio, TX, Madrid, Spain, Mexico City, Mexico
Institutions: San Antonio, TX
Results: In some studies, pulse blood pressure (pulse-BP) is a better predictor of coronary risk than systolic blood pressure (SBP). The underlying pathophysiologic mechanism is unknown, but may be linked to the relationship between measures of blood pressure and insulin resistance.
The relation of SBP, diastolic blood pressure (DBP), and pulse-BP to fasting insulin concentration and insulin resistance was examined in the Mexico City Diabetes Study (MCDS, n = 1771), San Antonio Heart Study (SAHS: Mexican Americans [SA-MA, n = 1260] and non-Hispanic whites [SA-NHW, n = 710), and Spanish Insulin Resistance Study (SIRS, n = 1675). Nondiabetic individuals aged 35-64 years who were not treated with antihypertensive medications were eligible for analysis. In each population, insulin resistance was defined as a homeostasis model of assessment >75 percentile.
The relation of blood pressure to fasting insulin concentration was analyzed by partial correlation coefficients (Table). SBP and DBP tended to have stronger correlations with fasting insulin concentration than pulse-BP.
The area under the receiver operating characteristic curve (AUC) was used to assess the ability of SBP, DBP, and pulse-BP to detect subjects with insulin resistance. The AUC of SBP was greater than that of pulse-BP in MCDS (0.63 vs. 0.56, p <0.001), SA-MA (0.64 vs. 0.60, p <0.001), and SA-NHW (0.63 vs. 0.55, p <0.001), but was not statistically different in SIRS (0.60 vs. 0.58, p = 0.106). The AUC of DBP was also greater than that of pulse-BP in MCDS (0.62 vs. 0.56, p = 0.005) and SA-NHW (0.63 vs. 0.55, p = 0.024), but was not statistically different in SA-MA (0.62 vs. 0.60, p = 0.362) and SIRS (0.57 vs. 0.58, p = 0.664).
In summary, SBP and DBP are better correlates of insulin resistance than pulse-BP.