Ekim Seven1, Lise L N Husemoen, Kristian Wachtell, Hans Ibsen, Allan Linneberg, Jørgen L Jeppesen. 1. aCardiovascular Research Unit, Department of Internal Medicine, Copenhagen University Hospital Glostrup bResearch Centre for Prevention and Health, Copenhagen University Hospital Glostrup, Glostrup cFaculty of Health Sciences, University of Copenhagen, Copenhagen dDepartment of Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark.
Abstract
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 -1.8 mmHg (95% CI -2.8 to -0.7), whereas weight gain with an increase in SBP of 1.9 mmHg (95% CI 1.2 to 2.6), both with P less than 0.001. Adding fasting insulin, 2-h insulin, Δfasting 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.
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 -1.8 mmHg (95% CI -2.8 to -0.7), whereas weight gain with an increase in SBP of 1.9 mmHg (95% CI 1.2 to 2.6), both with P less than 0.001. Adding fasting insulin, 2-h insulin, Δfasting 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.
Authors: Ambereen K Mehta; Ruchi S Doshi; Zoobia W Chaudhry; David K Jacobs; Rachit M Vakil; Clare J Lee; Sara N Bleich; Jeanne M Clark; Kimberly A Gudzune Journal: Prev Med Date: 2016-06-30 Impact factor: 4.018
Authors: Allan Linneberg; Rikke K Jacobsen; Tea Skaaby; Amy E Taylor; Meg E Fluharty; Jørgen L Jeppesen; Johan H Bjorngaard; Bjørn O Åsvold; Maiken E Gabrielsen; Archie Campbell; Riccardo E Marioni; Meena Kumari; Pedro Marques-Vidal; Marika Kaakinen; Alana Cavadino; Iris Postmus; Tarunveer S Ahluwalia; S Goya Wannamethee; Jari Lahti; Katri Räikkönen; Aarno Palotie; Andrew Wong; Christine Dalgård; Ian Ford; Yoav Ben-Shlomo; Lene Christiansen; Kirsten O Kyvik; Diana Kuh; Johan G Eriksson; Peter H Whincup; Hamdi Mbarek; Eco J C de Geus; Jacqueline M Vink; Dorret I Boomsma; George Davey Smith; Debbie A Lawlor; Aliaksei Kisialiou; Alex McConnachie; Sandosh Padmanabhan; J Wouter Jukema; Chris Power; Elina Hyppönen; Martin Preisig; Gerard Waeber; Peter Vollenweider; Tellervo Korhonen; Tiina Laatikainen; Veikko Salomaa; Jaakko Kaprio; Mika Kivimaki; Blair H Smith; Caroline Hayward; Thorkild I A Sørensen; Betina H Thuesen; Naveed Sattar; Richard W Morris; Pål R Romundstad; Marcus R Munafò; Marjo-Riitta Jarvelin; Lise Lotte N Husemoen Journal: Circ Cardiovasc Genet Date: 2015-11-04