Relatively lower central aortic pressure in patients with impaired insulin sensitivity and resistance: the Toon Health Study.

OBJECTIVE

Central aortic blood pressure (BP) has been postulated to correlate more closely with cardiovascular disease risk than brachial cuff BP. However, the effect of insulin sensitivity and resistance on central BP is not fully understood. Here, we evaluated the associations between insulin sensitivity/resistance and central BP using the oral glucose tolerance test.

METHODS

A total of 1034 Japanese participants were enrolled in this study. The absolute pressure of the late systolic peak (SBP2) of the brachial BP obtained by the radial waveform was considered to be the central systolic BP. Oral glucose tolerance test was performed by administering 75 g of glucose, and blood samples were obtained at 0, 60, 120 min after glucose loading.

RESULTS

Mean SBP2 was found to be lower than mean brachial systolic BP (SBP) (119 ± 20, 126 ± 19 mmHg, P < 0.001), and differences between SBP and SBP2 were significantly larger in patients with reduced insulin sensitivity (-8.2 ± 5.2, -7.2 ± 5.3, -7.1 ± 5.1, and -6.5 ± 4.9 mmHg, in the first, second, third and fourth quartiles, respectively; P = 0.002) and increased insulin resistance (-6.6 ± 5.1, -6.6 ± 4.8, -7.3 ± 4.8, -8.5 ± 5.6 mmHg, P < 0.001). Multiple linear regression analysis identified reduced insulin sensitivity (β = 0.067, P = 0.033) and increased insulin resistance (β = -0.081, P = 0.009) as independent determinants of the difference between SBP and SBP2.

CONCLUSION

Given that both insulin sensitivity and insulin resistance were found to be significant determinants of the difference between SBP and SBP2 in a healthy general population, we suggest measuring the SBP2 in individuals with impaired insulin action in order to accurately assess their risk of developing cardiovascular disease.