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Cited by 421Diabetes, Cardiovascular Risks, and LipoproteinsBlood Pressure and Hypertension StudiesCardiovascular Function and Risk Factors

Racial Differences in the Relation between Blood Pressure and Insulin Resistance

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Saad, Mohammed F., Lillioja, Stephen, Nyomba, Bulangu L., Castillo, Charles, Ferraro, Robert, De Gregorio, Michele, Ravussin, Eric, Knowler, William C. +3 more·1991·New England Journal of Medicine
DOI 10.1056/nejm199103143241105
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Abstract

BACKGROUND: Insulin resistance and the concomitant compensatory hyperinsulinemia have been implicated in the pathogenesis of hypertension. However, reports on the relation between insulin and blood pressure are inconsistent. This study was designed to investigate the possibility of racial differences in this relation. METHODS: We studied 116 Pima Indians, 53 whites, and 42 blacks who were normotensive and did not have diabetes; the groups were comparable with respect to mean age (29, 30, and 31 years, respectively) and blood pressure (113/70, 111/68, and 113/68 mm Hg, respectively). Insulin resistance was determined by the euglycemic-hyperinsulinemic clamp technique during low-dose (40 mU per square meter of body-surface area per minute) and high-dose (400 mU per square meter per minute) insulin infusions. RESULTS: The Pima Indians had higher fasting plasma insulin concentrations than the whites or blacks (176, 138, and 122 pmol per liter, respectively; P = 0.002) and lower rates of whole-body glucose disposal during both the low-dose (12.7, 17.1, and 19.5 mmol per minute; P less than 0.001) and the high-dose (38.0, 43.1, and 45.7 mmol per minute; P less than 0.001) insulin infusions. After adjustment for age, sex, body weight, and percentage of body fat, mean blood pressure (calculated as 1/3 systolic pressure + 2/3 diastolic pressure) was significantly correlated with the fasting plasma insulin concentration (r = 0.42) and the rate of glucose disposal during the low-dose (r = -0.41) and high-dose (r = -0.49) insulin infusions (P less than 0.01 for each) in whites, but not in Pima Indians (r = -0.06, -0.02, and -0.04, respectively) or blacks (r = -0.10, -0.04, and 0.02, respectively). CONCLUSIONS: The relations between insulinemia, insulin resistance, and blood pressure differ among racial groups and may be mediated by mechanisms active in whites, but not in Pima Indians or blacks.

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Crossref · 10.1056/nejm199103143241105

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  • Pima Indians have a high prevalence of obesity but relatively low rates of hypertension compared with white individuals.

    “Pima Indians have a high prevalence of obesity but relatively low rates of hypertension compared with white individuals32.”

    From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [32]

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Authors
Saad, M. F., Lillioja, S., Nyomba, B. L., Castillo, C., Ferraro, R., De Gregorio, M., Ravussin, E., Knowler, W. C., Bennett, P. H., Howard, B. V., & Bogardus, C.
Affiliations
  • National Institutes of Health (US)
  • National Institute of Diabetes and Digestive and Kidney Diseases (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1991-03-14
Volume
324
Issue
11
Pages
733-739
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199103143241105
OpenAlex
W2316528604
Cited by
421
References
37
Citations by year
2025: 3 · 2024: 4 · 2023: 2 · 2022: 7 · 2021: 4 · 2020: 1 · 2019: 7 · 2018: 2 · 2017: 9 · 2016: 6 · 2015: 3 · 2014: 7 · 2013: 3 · 2012: 7
FWCI
24.80
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
  • Figshare (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
insulin resistance, blood pressure, racial differences, Pima Indians, hyperinsulinemia, insulin levels, glucose disposal, hypertension pathogenesis, hyperinsulinemic-euglycemic clamp, normotensive subjects, African Americans, white, insulin dose-response, body fat percentage, body weight, sex differences, age differences
MeSH terms
Adult, Analysis of Variance, Arizona, Black or African American, Blood Pressure, Energy Metabolism, Female, Humans, Indians, North American, Insulin, Insulin Resistance, Male, United States, Black People, White People, Racial Groups

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