Prehypertension and Insulin Resistance in a Nationally Representative Adult Population

Prehypertension is associated with increased risk of cardiovascular disease and progression to hypertension. Insulin resistance (IR) is also related to cardiovascular risk. It is unknown whether individuals with prehypertension also have higher IR. The purpose of this study was to examine the association between prehypertension and IR. The National Health and Nutrition Examination Survey 1999–2002 was used to determine odds of IR by fasting insulin level >12.2 μU/mL or homeostasis model assessment (HOMA) ≥2.6 among nondiabetic adults aged 20 to 80 years across blood pressure categories. Compared with normotensives, odds of IR were over 60% higher for prehypertensive individuals by both IR measures: fasting insulin (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.12–2.48) and HOMA (OR, 1.67; 95% CI, 1.22–2.30). After stratifying by sex, IR was associated with prehypertension in only men for both IR measures. In conclusion, prehypertension is associated with higher IR in men, which may confer additional cardiovascular disease risk.