Patterns and predictors of hypertension incidence among Hispanics and non-Hispanic whites: the San Luis Valley Diabetes Study

Abstract

Objectives: To determine whether Hispanics are at lower risk for the development of hypertension than non-Hispanic Whites. We also examined selected predictors of hypertension incidence and explored the role of markers of insulin resistance in the development of hypertension.

Design: A cohort study of a geographically-based sample of Hispanic and non-Hispanic white southern Colorado residents who were re-examined an average of 4 years after their baseline examination.

Methods: These analyses included 664 participants who were normotensive and confirmed nondiabetic by an oral glucose tolerance test at their baseline examination. Hypertension was defined as systolic blood pressure > or = 140 mmHg or diastolic blood pressure > or = 90 mmHg or use of antihypertensive medication.

Results: Hispanics and non-Hispanic Whites had similar hypertension incidence rates. The strongest predictors of hypertension incidence were baseline blood pressure and age. Higher baseline heart rates and higher body mass index also predicted hypertension. Increased fasting insulin levels were associated with hypertension incidence among lean participants, though the association disappeared once baseline blood pressure levels were added to the models. Models investigating change in systolic or diastolic blood pressure levels found higher baseline levels of insulin area under the glucose tolerance curve predicted greater increases in systolic blood pressure in non-Hispanic Whites only.

Conclusions: Hypertension incidence rates were similar in Hispanics and non-Hispanic Whites. Higher levels of insulin area were associated with larger increases in systolic blood pressure among non-Hispanic Whites only.