Epidemiology/Population Glucagon-Like Peptide-1 and Blood Pressure in Young and Healthy Adults from the General Population Philipp Krisai, Stefanie Aeschbacher, Tobias Schoen, Matthias Bossard, Jan Gerrit van der Stouwe, Laura Dörig, John Todd, Joel Estis, Martin Risch, Lorenz Risch, David Conen Abstract—Hypertension and diabetes mellitus are highly correlated, but the underlying mechanisms are only partly understood. Therefore, the aim of our study was to investigate the relationships between plasma levels of glucagon-like peptide-1, a key factor in the regulation of glucose homeostasis, and various blood pressure indices. Healthy adults aged 25 to 41 years were enrolled in a population-based study. Established cardiovascular disease, diabetes mellitus, or a body mass index >35 kg/m2 were exclusion criteria. Fasting plasma glucagon-like peptide-1 levels as determined with a novel high-sensitive assay and ambulatory blood pressure data were available in 1479 participants not using antihypertensive treatment. Median age of our population was 38 years. Mean systolic and diastolic blood pressure across increasing glucagon-like peptide-1 quartiles were 120.6, 122.8, 123.2, and 124.9 mm Hg and 77.1, 78.7, 78.9, and 79.9 mm Hg, respectively. We found a linear relationship of glucagon-like peptide-1 with 24-hour ambulatory blood pressure after multivariable adjustment (β per 1 log-unit increase 2.01; 95% confidence interval, 1.02–3.00; P35 kg/m2, established cardiovascular disease, or any other severe illness. For the present analysis, we also excluded participants with invalid 24-hour BP measurements as defined below (n=90) and those currently using BP-lowering treatment (n=30), leaving 1479 subjects with available GLP-1 measurements. The study protocol was approved by the local ethics committee, and informed written consent was obtained from each participant.

BP Assessment Ambulatory BP measurements were obtained using a validated automatic device (BR-102 plus; Schiller AG, Switzerland).28 BP measurements were performed every 15 minutes from 07:30 to 22:00 and every 30 minutes in the remaining time period. Individual diaries were used to define awake and asleep BP values. If individuals had 43.6

...

Age, y

38.5 (33.2; 40.9)

38.8 (33.7; 40.9)

37.5 (32.5; 40.6)

37.5 (31.8; 40.6)

0.01

Sex (men)

150 (40.5)

180 (48.8)

176 (47.4)

184 (49.9)

0.05

BMI, kg/m2

23.5 (21.4; 26.4)

24.3 (22.0; 26.6)

24.3 (22.0; 27.3)

24.4 (22.4; 27.6)

0.003

Smoking  Current

0.01 52 (14.1)

77 (20.9)

80 (21.6)

93 (25.2)

 Past

88 (23.8)

80 (21.7)

84 (22.6)

86 (23.3)

 Never

230 (62.2)

210 (56.9)

207 (55.8)

190 (51.5)

Alcohol intake, g/d

0.0 (0.0; 1.7)

0.4 (0.0; 1.7)

0.6 (0.0; 1.7)

0.8 (0.0; 2.2)

0.03

Regular fruit/vegetable intake*

85 (23.0)

80 (21.7)

62 (16.7)

62 (16.8)

0.06

High intake of meat/cold cut* Physical activity, min/wk

93 (25.1) 180 (60; 360)

119 (32.3)

111 (29.9)

100 (27.1)

0.2

180 (60; 360)

120 (60; 360)

180 (45; 360)

0.7

LDL-C, mmol/L

2.7 (2.3; 3.4)

3.0 (2.5; 3.7)

3.0 (2.5; 3.5)

3.0 (2.4; 3.6)

0.0003

HDL-C, mmol/L

1.6 (1.3; 1.8)

1.5 (1.2; 1.8)

1.5 (1.2; 1.8)

1.5 (1.2; 1.8)

0.006

Hemoglobin A1c, %

5.4 (5.3; 5.7)

5.5 (5.2; 5.7)

5.5 (5.2; 5.7)

5.5 (5.3; 5.7)

HOMA-IR

1.1 (0.8; 1.5)

1.2 (0.9; 1.7)

1.3 (1.0; 2.0)

1.5 (1.0; 2.3)