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Related Experiment Videos

Essential hypertension: an insulin-resistant state.

E Ferrannini1, S M Haffner, M P Stern

  • 1C.N.R. Institute of Clinical Physiology, University of Pisa, Italy.

Journal of Cardiovascular Pharmacology
|January 1, 1990
PubMed
Summary

High blood pressure is linked to insulin resistance, a condition where the body doesn't use insulin effectively. This study shows insulin resistance is independently related to higher blood pressure even after accounting for other factors.

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Area of Science:

  • Cardiovascular Science
  • Metabolic Science
  • Endocrinology

Background:

  • Epidemiological data indicate a strong association between hyperinsulinemia and elevated blood pressure.
  • Obesity, male sex, and age correlate with increased blood pressure and insulin levels in non-diabetic individuals.
  • Hypertensive individuals often exhibit metabolic disturbances, including hyperinsulinemia, glucose intolerance, and dyslipidemia.

Purpose of the Study:

  • To investigate the independent relationship between plasma insulin concentrations and blood pressure.
  • To determine if essential hypertension is characterized by insulin resistance.
  • To explore the association between parental history of non-insulin-dependent diabetes mellitus (NIDDM), hyperinsulinemia, blood pressure, and lipid levels.

Main Methods:

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  • Utilized epidemiological data and physiological studies, including the euglycemic insulin clamp technique.
  • Assessed whole-body glucose uptake and insulin's effects on hepatic glucose output and lipolysis.
  • Employed perfused forearm studies to examine local insulin effects on glucose uptake and glycogen synthesis in skeletal muscle.

Main Results:

  • Essential hypertension is identified as a state of insulin resistance, with a 40% reduction in insulin-stimulated glucose uptake in lean, non-diabetic hypertensive subjects.
  • Insulin's actions on hepatic glucose output, lipolysis, and lipid oxidation remain preserved in hypertensive individuals.
  • Local hyperinsulinemia in forearm studies showed subnormal glucose uptake and glycogen synthesis in the skeletal muscle of hypertensive individuals.
  • In the San Antonio Heart Study, parental NIDDM history correlated with hyperinsulinemia and higher blood pressure in non-diabetic individuals.

Conclusions:

  • Insulin resistance is a key feature of essential hypertension, impacting glucose metabolism.
  • Hyperinsulinemia is independently linked to elevated blood pressure, suggesting a direct physiological connection.
  • Metabolic abnormalities associated with obesity and diabetes significantly overlap with hypertension.