Changes in blood pressure and plasma catecholamine levels during prolonged hyperinsulinemia

Hyperinsulinemia has been shown to induce activation of the sympathetic nervous system and vasodilatation. Whether these effects result in changes in blood pressure (BP) is discussed controversially. We measured BP and plasma catecholamine levels in 30 healthy men during a 60-minute baseline phase and 360-minute period of insulin infusion. In a double-blind, between-subject comparison, insulin was infused at a low rate (1.5 mU insulin/kg per minute) in one half of the subjects and at a high rate (15 mU/kg per minute) in the other half. Throughout the experiments, blood glucose levels were held constantly within the normal range by a simultaneous infusion of glucose. Serum insulin levels increased to a plateau of 543 +/- 34 pmol/L during low rate and to 24,029 +/- 1,595 pmol/L during high rate of insulin infusion. Compared with baseline, insulin infusion of either rate significantly increased systolic BP, BP amplitude, and heart rate (all P < .05). In comparison with the low rate of insulin infusion, the high rate provoked a more pronounced increase in heart rate (P < .02) and systolic BP (P < .05) but tended to decrease diastolic BP (P < .08) summing up to a distinctly more increased BP amplitude (P < .05). Plasma norepinephrine as well as epinephrine levels did not significantly change during the low-rate insulin infusion but significantly increased during high-rate insulin infusion (both P < .05). By showing a dose-dependent increasing influence of insulin on systolic BP and circulating catecholamine levels, the present study provides experimental evidence for the notion that hyperinsulinemia contributes to the development of hypertension.