© 1998 Oxford University Press
research-article |
High free fatty acid concentration: an independent risk factor for hypertension in the Paris Prospective Study
aInstitut National de la Santé et de la Recherche Médlcale. Unit 21 Faculty of Médicine Paris-Sud 94807 Villejuif, France
bHôpital Henri Mondor 94000 Créteil, France
cFacuìté des Sciences Pharmaceutiques et Blologiques de Universlté de Paris V. 75006 Paris. France
dInstitut National de la Santé et de la Recherche Médicale. Unit 258, Hôpital Broussals 75674 Paris, France
Reprint requests to: Dr Anne Fagot-Campagna. Division of Diabetes Translation, National Center for Chronic Diseases Prevention and Health Promotion, CDC, 4770 Buford Hwy. NE (MS-K10), Atlanta, GA 30341–3724, USA
BACKGROUND: An inconsistent relationship has been reported between insulin and hypertension incidence. Free fatty acids are related to insulin-resistance and may have a direct effect on hypertension. We examined the effect of free fatty acids on hypertension incidence, taking into account other abnormalities of the insulin-resistance syndrome.
METHODS: In all, 2968 non-hypertensive and non-diabetic Caucasian men were followed for 3 years. Hypertension incidence was defined as systolic blood pressure (SBP) 
160 mmHg or diastolic blood pressure (DBP) 95 mmHg or drug treatment for hypertension.
RESULTS: Free fatty acid elevation was a highly significant risk factor for hypertension when controlled for age, family history of hypertension, alcohol consumption, body mass index, iliac circumlerence and weight change. Further controlling for SBP, heart rate and fasting insulin and glucose did not decrease its predictive power (hazard rate ratio [RR]=1.58, 95% confidence interval [CI]: 1.30–1.91 comparing the 90th to the 10th percentiles at fasting; RR=1.54, 95% CI: 1.33–1.79 at 2 h). In a forward stepwise model controlled for age, family history of hypertension, alcohol consumption and SBP, the selected variables explaining the occurrence of hypertension were, in order, weight change, 2-h free fatty adds, iliac circumference and fasting free fatty acids, whereas body mass index, heart rate, insulin, glucose and other lipids did not enter into the model.
CONCLUSIONS: Free fatty acids elevation, when controlled for all known risk factors and other abnormalities of the insulin-resistance syndrome, is a risk factor for hypertension. These results highlight the possible benefits of treatment using free fatty acid oxidation inhibitors.
Keywords Free fatty acids, obesity, essential hypertension, insulin, lipids, men
Accepted 23 January 1998
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