Mutual Effect Modification between Insulin Resistance and Endothelial Dysfunction in Predicting Incident Heart
Maria Perticone1, Raffaele Maio2, Simona Gigliotti3
1Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
Biomedicines
|August 26, 2023
Summary
Endothelial dysfunction and insulin resistance (homeostasis model assessment) are independent predictors of heart failure (HF) in hypertensive patients. These factors interact competitively, increasing HF risk significantly.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Hypertension Research
Background:
- Insulin resistance and endothelial dysfunction are independently linked to heart failure (HF) development.
- Understanding their combined impact and potential interactions is crucial for predicting HF incidence in hypertensive individuals.
Purpose of the Study:
- To determine if endothelial dysfunction and insulin resistance are independent predictors of incident HF.
- To investigate the potential interaction between endothelial dysfunction and insulin resistance in predicting HF.
Main Methods:
- A cohort of 705 never-treated hypertensive patients was followed for a median of 117 months.
- Endothelium-dependent vasodilation was assessed using acetylcholine infusion.
- Insulin resistance was measured by homeostasis model assessment (HOMA).
- Cox regression analysis was used to identify predictors of incident HF.
Main Results:
- Higher HOMA, serum hs-CRP, older age, and female sex were associated with incident HF.
- Lower endothelium-dependent vasodilation (maximal acetylcholine-stimulated forearm blood flow) and e-GFR predicted incident HF.
- HOMA and endothelial dysfunction showed a significant competitive interaction, increasing HF risk (HR = 6.548).
Conclusions:
- Both endothelial dysfunction and HOMA are independent and significant predictors of incident HF in hypertensive patients.
- A competitive interaction exists between HOMA and endothelial dysfunction, amplifying the risk of developing heart failure.
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