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American Journal of Epidemiology Advance Access published online on March 22, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj113
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received August 15, 2005
Accepted December 21, 2005

ORIGINAL CONTRIBUTIONS

Physical Activity, Insulin Sensitivity, and Hypertension among US Adults: Findings from the Insulin Resistance Atherosclerosis Study

Capri Gabrielle Foy 1 *, Kristie Long Foley 1, Ralph B. D'Agostino Jr. 1, David C. Goff Jr. 1, Elizabeth Mayer-Davis 2, and Lynne E. Wagenknecht 1

1 Department of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, NC
2 Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC

* To whom correspondence should be addressed.
Capri Gabrielle Foy, E-mail: cfoy{at}wfubmc.edu


  Abstract

Although regular physical activity is associated with less hypertension and improved insulin sensitivity, there is debate regarding the role of insulin sensitivity in hypertension. Thus, in this cross-sectional study, the authors investigated whether physical activity and insulin sensitivity were associated with hypertension. The sample consisted of 1,599 persons aged 40-69 years who participated in the Insulin Resistance Atherosclerosis Study. The outcome measure was hypertension as measured by a standard protocol. Energy expended in vigorous physical activity was calculated from a recall interview on past-year physical activity. Descriptive statistics revealed that 590 (37%) participants had prevalent hypertension. In adjusted logistic regression analysis, participants expending ≥150 kcal/day in vigorous physical activity had an odds ratio for hypertension of 0.73 (95% confidence interval (CI): 0.55, 0.98) in comparison with participants who were sedentary. Further adjustment for insulin sensitivity resulted in attenuation of the effect of vigorous physical activity on hypertension (odds ratio = 0.97, 95% CI: 0.71, 1.33), while the effect of insulin sensitivity was significant (odds ratio = 0.33, 95% CI: 0.26, 0.41). These results suggest that longitudinal studies are warranted to determine whether insulin sensitivity is a mediator of the relation between physical activity and hypertension.

Keywords: adult; aged; exercise; hypertension; insulin; insulin resistance.
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