Insulin, renin-aldosterone system and blood pressure in obese people
G Andronico1, S Cottone, M T Mangano
1Istituto di Clinica Medica e Malattie Cardiovascolari, Università di Palermo, Palermo, Italy. androp@unipa.it
Objective:
To evaluate the relationship between insulin, the renin-aldosterone system and blood pressure in obese subjects.
Design And Methods:
A cross sectional study of a group of severely obese normotensive subjects who were surgical candidates (n=39; mean BMI: 47.8+/-1.4) and a group of hypertensive patients (n=57; mean BMI: 28.0+/-0.7) twenty-nine of whom had BMI>27. All subjects were studied after 15 days on a balanced diet. Insulin, plasma renin activity and aldosterone were measured.
Results:
Fasting insulin, plasma renin activity and aldosterone were higher in severely obese normotensive subjects than in hypertensive subjects (respectively 32.3+/-3.0 vs 13.1+/-1.0 mU/l, P=0.0001; 1.34+/-0.22 vs 0.88+/-0.12 ng/ml/h, P=0.04; 137.2+/-16.2 vs 87.9+/-12.1 pg/ml, P=0.015). Insulin was related to BMI and to aldosterone both in normotensive and in hypertensive patients.
Conclusion:
Hyperinsulinemia itself does not determine hypertension; in some people it could play a vasodilator role in opposition to the renin-aldosterone system.
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