Physical Inactivity is an Important Lifestyle Determinant of Insulin Resistance in Hypertensive Patients

The purpose of the study is to assess the relative impact of lifestyle factors including physical inactivity, cigarette smoking, and alcohol intake on insulin resistance in hypertensive patients. In total, 872 hypertensive patients, of Chinese and Japanese origin, from the Stanford Asia and Pacific Program for Hypertension and Insulin Resistance were included for the current analysis. Homeostasis model assessment for insulin resistance (HOMA‐IR) and the insulin sensitivity index ISI 0,120 were chosen as surrogate measures of insulin resistance. Standardized interview‐administered questionnaires were used to obtain information on demographic and lifestyle characteristics. The sedentary hypertensive patients were more insulin resistant than the non‐sedentary hypertensive. There were significant differences in Log (HOMA‐IR) (0.06‐unit increases, p < 0.01) and Log (ISI 0,120 ) (0.05‐unit decreases, p < 0.01) between sedentary and non‐sedentary hypertensive patients after controlling demographic variables. There were no differences in insulin sensitivity in subjects with different smoking status. Neither smoking nor alcohol intake was persistently associated with insulin resistance in the analysis. Our results suggest that physical inactivity is an important lifestyle determinant of insulin resistance in hypertensive patients. The influences of smoking and alcohol intake on insulin resistance are less significant than physical inactivity in hypertensive subjects.

[1]  Daniel W. Jones,et al.  Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. , 2003, Hypertension.

[2]  S. Priori,et al.  2003 European Society of Hypertension-European Society of Cardiology Guidelines for the Management of Arterial Hypertension , 2004, Heart Drug.

[3]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[4]  T. Quertermous,et al.  Sagittal abdominal diameter is associated with insulin sensitivity in Chinese hypertensive patients and their siblings , 2003, Journal of Human Hypertension.

[5]  B. Fagerberg,et al.  Alcohol consumption, the metabolic syndrome and insulin resistance in 58-year-old clinically healthy men (AIR study). , 2002, Clinical science.

[6]  W. Yeh,et al.  Prevalence, awareness, treatment and control of hypertension in Taiwan: results of Nutrition and Health Survey in Taiwan (NAHSIT) 1993–1996 , 2001, Journal of Human Hypertension.

[7]  David Kerr,et al.  The effect of evening alcohol consumption on next-morning glucose control in type 1 diabetes. , 2001, Diabetes care.

[8]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[9]  S. Haffner,et al.  Associations Between Alcohol Consumption and Insulin Sensitivity and Cardiovascular Disease Risk Factors , 2000 .

[10]  J. Ranstam,et al.  Associations between smoking and β‐cell function in a non‐hypertensive and non‐diabetic populationSkaraborg Hypertension and Diabetes Project , 2000, Diabetic medicine : a journal of the British Diabetic Association.

[11]  N. Schneiderman,et al.  Validation of the insulin sensitivity index (ISI(0,120)): comparison with other measures. , 2000, Diabetes research and clinical practice.

[12]  D. Levy,et al.  Cross-classification of JNC VI blood pressure stages and risk groups in the Framingham Heart Study. , 1999, Archives of internal medicine.

[13]  N. Chaturvedi,et al.  Relationships of fasting and postload glucose levels to sex and alcohol consumption. Are American Diabetes Association criteria biased against detection of diabetes in women? , 1999, Diabetes care.

[14]  E. Jéquier,et al.  Alcohol intake and body weight: a paradox. , 1999, The American journal of clinical nutrition.

[15]  A. Goldberg,et al.  Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men. , 1998, Metabolism: clinical and experimental.

[16]  Worthington,et al.  Associations of smoking, alcohol and physical activity with risk factors for coronary heart disease and diabetes in the first follow‐up cohort of the Heart Disease and Diabetes Risk Indicators in a Screened Cohort study (HDDRISC‐1) , 1998, Journal of internal medicine.

[17]  R N Bergman,et al.  Intensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. , 1998, JAMA.

[18]  K. Yano,et al.  Effects of walking on mortality among nonsmoking retired men. , 1998, The New England journal of medicine.

[19]  E. Bonora,et al.  Cigarette smoking and insulin resistance in patients with noninsulin-dependent diabetes mellitus. , 1997, The Journal of clinical endocrinology and metabolism.

[20]  D J Foley,et al.  Smoking history in middle age and subsequent cognitive performance in elderly Japanese-American men. The Honolulu-Asia Aging Study. , 1997, American journal of epidemiology.

[21]  N. Day,et al.  Cigarette smoking is not associated with hyperinsulinemia: evidence against a causal relationship between smoking and insulin resistance. , 1996, Metabolism: clinical and experimental.

[22]  W. Poewe,et al.  Insulin sensitivity and regular alcohol consumption: large, prospective, cross sectional population study (Bruneck study) , 1996, BMJ.

[23]  L. Lind,et al.  Prevalence of insulin resistance in essential hypertension , 1995, Journal of hypertension.

[24]  C M Burchfiel,et al.  A Prospective Study of the Health Effects of Alcohol Consumption in Middle‐Aged and Elderly Men: The Honolulu Heart Program , 1994, Circulation.

[25]  A. Avogaro,et al.  Alcohol, glucose metabolism and diabetes. , 1993, Diabetes/metabolism reviews.

[26]  U. Smith,et al.  Smoking induces insulin resistance—a potential link with the insulin resistance syndrome , 1993, Journal of internal medicine.

[27]  R. DeFronzo,et al.  Insulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease , 1991, Diabetes Care.

[28]  P. Cryer,et al.  Effects of exercise and lack of exercise on insulin sensitivity and responsiveness. , 1988, Journal of applied physiology.

[29]  R. Turner,et al.  Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man , 1985, Diabetologia.

[30]  J F Sallis,et al.  Behavioral science research in diabetes: lifestyle changes related to obesity, eating behavior, and physical activity. , 2001, Diabetes care.

[31]  C. A. Contreras Addressing Cardiovascular Health in Asian Americans and Pacific Islanders: A Background Report. , 1999, Asian American and Pacific Islander journal of health.

[32]  P. Allhoff,et al.  The Honolulu Heart Program , 1991 .

[33]  M. Saad,et al.  Insulin resistance in essential hypertension. , 1990, Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas.