Recalculated HOMA-IR and Recorded Blood Pressure Changes in Treated Internal Medicine Patients: An Exploratory Retrospective Study

Background/Objectives: In treated patients, concurrent metabolic and blood pressure (BP) changes are difficult to interpret without complete treatment histories. We examined the association between change in homeostasis model assessment of insulin resistance (HOMA-IR) and systolic BP (SBP), and described trajectories by prescribed management category. Methods: This exploratory retrospective cohort included 150 patients (132 inpatients and 18 outpatients at baseline), with visits labeled baseline, month 3, and month 6; exact dates were unavailable. Four nonrandomized categories were compared by baseline prescription, without adherence data. HOMA analyses excluded two participants with explicit insulin entries; complete-case regression used heteroscedasticity-consistent (HC3) confidence intervals (CIs). Results: The principal SBP coefficient was 2.20 mmHg per HOMA-IR doubling (95% CI −1.90 to 6.31; n = 99). Restrictions to no recorded baseline diabetes (n = 71) or no pharmacological glucose-lowering entry (n = 77) also yielded imprecise estimates. SBP decreased by 2.07–8.23 mmHg across prescribed categories, but adjusted contrasts were uncertain (global p = 0.743). The waist–SBP coefficient did not meet the multiplicity criterion (q = 0.107). Of 724 recorded BP values, 720 were multiples of 5 mmHg. Conclusions: The association between HOMA-IR change and recorded SBP change remained uncertain, and the efficacy of prescribed diet or omega-3 supplementation could not be assessed. The principal contribution of the study is to show how incompletely documented medication exposure, adherence, visit timing, and measurement conditions limit the interpretation of serial HOMA-IR and routine BP values in treated patients.