Insulin resistance and increased body mass index in women developing hypertension in pregnancy

J. R. Sowers, R. J. Sokol, P. R. Standley, M. Kruger, B. A. Mason, P. S. Sowers, D. B. Cotton

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background and Aim: Several retrospective studies have suggested that women who develop hypertension during pregnancy characteristically have insulin resistance and obesity, but this interrelationship has not been studied prospectively. Methods and Results: Young women presenting for prenatal care were clinically evaluated and had a Glucose Tolerance Test (GTT) at approximately 19 weeks' gestation. Serum insulin, C-peptide and glucose were measured 1 hour after a 50-gram oral glucose load. Subsequently, the patients were classified as normal, gestational hypertensives or preeclamptics, by standard criteria. Of the 164 women who had oral glucose tolerance testing and who delivered at an urban medical center, eleven developed hypertension in pregnancy. Three of these 11 hypertensives had proteinuria and other clinical characteristics of preeclampsia. At the time at which the oral glucose tolerance study was conducted (approximately 19 weeks), the group who developed hypertension had a greater body mass index (BMI) (37±3 vs 26±0.6) (p<0.001), greater 1-hour insulin (93±16 vs 16±3 mU/ml) and glucose (126±8 vs 98±2 m/dl) (p<0.005) levels than those women not developing hypertension. Stepwise discriminant function analysis revealed that the characteristic at the time of the oral GTT that was the most significant predictor for the development of hypertension in pregnancy was BMI. Conclusions: Women who develop new-onset hypertension in pregnancy have greater BMI, as well as evidence of insulin resistance in the second trimester than women who remain normotensive. Elevated BMI in the second trimester of pregnancy is a strong predictor of development of new-onset hypertension in pregnancy in this population of largely African American urban women.

Original languageEnglish (US)
Pages (from-to)141-146
Number of pages6
JournalNutrition, Metabolism and Cardiovascular Diseases
Issue number3
StatePublished - Sep 1996


  • BMI
  • Gestational hypertension
  • Insulin resistance
  • New-onset hypertension
  • Preeclampsia

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine


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