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P72 Objective: To examine the association between  hyperinsulinemia and blood pressure independent of body mass among  nondiabetic white non-Hispanic, black non-Hispanic, and Mexican  American adults. Methods: We examined this relationship  using data from 8004 adults aged ≥20 years from the Third National  Health and Nutrition Examination Survey (1988-1994). Univariate  differences in body mass index (BMI), waist-to-hip ratio (WHR),  glycosylated hemoglobin (HbA 1c ), fasting plasma glucose and  C-peptide were examined between normotensives and hypertensives within  each racial or ethnic group. Logistic regression was used to obtain the  likelihood of being hypertensive across race specific tertiles of  C-peptide adjusting for age, sex, education, BMI, and WHR.  Results: The prevalence of hypertension was 21.1% among  whites, 24.6% among blacks, and 10.9% among Mexican Americans.  Hypertensives were older, with higher BMI, WHR, HbA 1c ,  fasting plasma glucose, and fasting C-peptide levels than  normotensives. Also, the prevalence of hypertension increased  significantly with C-peptide level for each of the racial or ethnic  groups. Persons with a C-peptide in the upper tertile were more likely  to be hypertensive than those with a C-peptide level in the lower  tertile after adjustment for age, sex, education, and BMI (Mexican  Americans OR=3.3, 95% CI=2.2-4.8; whites OR=2.0, 95% CI=1.5-2.7,  blacks OR=2.0, 95% CI=1.3-3.0). Adjustment for WHR attenuated the  association between C-peptide and hypertension (Mexican Americans  OR=3.0, 95% CI=2.0-4.5; whites OR=1.6,95% CI=1.2-2.2; blacks OR=1.7,  95% CI=1.1-2.6). Conclusion: These results suggest that  hyperinsulinemia is associated with hypertension independent of BMI and  diabetes. Further, WHR was identified as a confounder and should be  taken into account in addition to BMI when evaluating the relationship  between C-peptide and hypertension.

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Association between Hyperinsulinemia and Hypertension among White, Black, and Mexican American Adults. Results from the Third National Health and Nutrition Examination Survey, 1988-1994.