THE IMPACT OF INSULIN RESISTANCE ON BLOOD PRESSURE VARIABILITY IN TREATED HYPERTENSIVE PATIENTS

Objective: Insulin resistance (IR) is a key factor in the development of hypertension (HTN) and may disrupt blood pressure variability (BPV), potentially causing target organ damage. The triglyceride-glucose (TyG) index has been identified as a reliable marker of IR. This study aimed to evaluate whether insulin resistance influences blood pressure variability over a 24-hour period in treated hypertensive subjects. Design and method: The study included 104 treated hypertensive subjects (52 men and 52 women, mean age 64.22 ± 12.51 years) who met the inclusion criteria. Patients with type 2 diabetes mellitus on insulin treatment were excluded. Anthropometric data were collected, and body mass index (BMI) was calculated. Laboratory tests were performed to assess fasting glucose, triglyceride, and cholesterol levels. A 24-hour ambulatory blood pressure monitoring (ABPM) was conducted, and BPV was evaluated using the average real variability (ARV) parameter. Statistical analysis was applied to assess the correlations between the triglyceride-glucose index and BPV, as well as between ABPM-derived blood pressure values. Results: Significant correlations were found between triglyceride/glucose index and systolic BP variability over 24 hours (p = 0.046, CI: 0.002917 to 0.3739, r2= 0.03818). Additionally, significant associations were found between TyG index and daytime systolic BP (p = 0.037, CI: 0.0183 to 0.3816, r2= 0.04160) as well as body mass index (p = 0.0006, CI: 0.1490 to 0.4931, r2= 0.1103). Conclusions: Higher TyG index levels were associated with increased systolic BP variability over a 24-hour period and elevated daytime BP levels. Body mass index also showed a significant correlation with the TyG index. These findings suggest that metabolic disturbances such as obesity and insulin resistance may contribute to blood pressure instability. Managing insulin resistance in hypertensive patients is essential to reduce BPV and prevent target organ damage.