Body mass index and insulin resistance as independent predictors of hypertension in postmenopausal women

Abstract

Aim: Although previous studies confirmed the association between obesity and hypertension, the underlying pathophysiological mechanism is not well elucidated, specially considering the fact that discordant results exist when examining the independent role of obesity and/or insulin resistance on risk for hypertension onset. Therefore, we aimed to examine if obesity [as measured with body mass index (BMI)] is a predictor for hypertension, independently of insulin resistance [as measured with Homeostasis model assessment of insulin resistance (HOMA-IR)] in the cohort of postmenopausal women. Methods: A total of 150 postmenopausal women non-treated with medications(among them 44.7% hypertensive)were included in cross-sectional study. Anthropometric and biochemical parameters, so as blood pressure were obtained. HOMA-IR was calculated. Results: Multivariate logistic regression analysisrevealed that both, BMI and HOMA-IR were the independent predictors of blood pressure in postmenopausal women (OR=1.240, p=0.035 and OR=2.419, p=0.008, respectively). Rise in BMI for 1 kg/m2 enhanced the probability for higher blood pressure by 24%. Also, elevation in HOMA-IR for 1 unit, rose the probability for higher blood pressure almost 2.5 times. Even 47% of variation in blood pressure could be explained with this Model. Also, this Model correctly classified 76% of postmenopausal women having hypertension. Conclusions: Both, obesity and insulin resistance are the independent predictors of blood pressure in postmenopausal women.

Cilj: Premda su ranije studije potvrdile vezu između gojaznosti i hipertenzije, patofiziološki mehanizam ove povezanosti još uvek nije rasvetljen, naročito što postoje oprečni rezultati kada je u pitanju nezavisna uloga gojaznosti i/ili insulinske rezistencije u nastanku hipertenzije. Stoga je cilj studije bio da se ispita da li je gojaznost [merena indeksom telesne mase (ITM)] prediktor za nastanak hipertenzije, nezavisno od insulinske rezistencije [merene HOMA indeksom (HOMA-IR)] u kohorti žena u postmenopauzi. Metode: Ukupno 150 žena u postmenopauzi koje nisu na terapiji (među njima 44,7% sa hipertenzijom) su uključene u studiju preseka. Antropometrijski i biohemijski parametri, kao i krvni pritisak su mereni. HOMA-IR je računat. Rezultati: Multivarijantna logistička regresiona analiza je pokazala da su i ITM (OR=1,240; p=0,035) i HOMA-IR (OR=2,419; p=0,008)nezavisni prediktori krvnog pritiska kod žena u postmenopauzi. Povećanje ITMza1 kg/m2 povećava verovatnoću za pojavu hipertenzije za 24%. Takođe, porast HOMA-IR za 1 jedinicu povećava verovatnoću za pojavu hipertenzije za skoro 2,5 puta. Čak 47% varijacije u vrednosti krvnog pritiska može biti objašnjeno ovim modelom. Takođe, ovaj model je ispravno klasifikovao 76% žena u postmenopauzi koje imaju hipertenziju. Zaključak: I gojaznost, i insulinska rezistencija su nezavisni prediktori krvnog pritiska kod žena u postmenopauzi.