[Vascular reactivity in patients with arterial hypertension and metabolic disorders]

Endothelium function was assessed from endothelium-dependent vasodilation and plasma endothelin-1 (ET-1) levels in 16 patients with arterial hypertyension (AH) and insulin resistance (IR) and compared with that in 22 patients with AH without IR. IR was diagnosed indirectly from the fasting glucose-to-insulin ratio in venous blood below 6. Additional studies included round-the-clock monitoring arterial pressure, reactive hyperemia test, and immunoreactive ET-1 assay. Major changes revealed in the patients with AH and IR were a smaller-than-normal diameter of the humeral artery, its decreased incremental growth, and elevated plasma ET-1 compared with the AH patients without IR. It is concluded that patients with AH and IR exhibit more pronounced dysfunction of endothelium than patients with AH without metabolic disorders.