[Hyperinsulinism and lipid changes in the early stages of essential arterial hypertension]

The purpose of this study was to evaluate the presence of insulin-resistance in non-obese, non-diabetic patients with mild to moderate essential arterial hypertension of recent diagnosis and without prior pharmacological treatment and its relationship with the lipid alteration found in those patients. Twenty-one controls (9 M/12F) and twenty-nine patients (19 M/10 F) were studied. The control group presented mean age: 29 +/- 1.5 years, BMI: 23.9 +/- 0.46 Kg/m2, SBP: 112.6 +/- 2.9 mm Hg, DBP: 68.0 +/- 2.9 mm Hg. The patient group presented mean age: 35 +/- 1.4 years, BMI: 27.3 +/- 0.45 Kg/m2, SBP: 140 +/- 26 mm Hg, DBP: 95.1 +/- 1.4 mm Hg. The fasting levels of glucose, insulin and lipids were measured in each individual. Both controls and patients were subjected to an oral glucose tolerance test (OGTT) with determination of glucose and insulin at 30, 60, and 120 minutes. The patients had significantly (p < 0.05) increased plasma glucose at 0, 30, 60 and 120 min. and increased (p < 0.05) plasma insulin levels at O and 120 min compared to controls. The G/I ratio was significantly lower (p < 0.005) in the hypertensive group, at 0 h and 120 min. Abnormalities in fasting lipid profile were also observed in the patients including a significant increase in TG, Cholesterol, VLDL-C and LDL-C. These increases were especially evident in men and those with higher BMI. There was a positive and significant association between basal-insulin and TG, VLDL-C and DBP in hypertensive patients. We conclude that hyperinsulinemia is present in the majority of hypertensive patients and that hyperinsulinemia is associated with lipid abnormalities specially in men and the most individuals with higher BMI.