[Hypertension and hyperinsulinism in non-insulin-dependent diabetes. A study of 230 patients]

This study was designed to analyse the relationship between hypertension and hyperinsulinemia in type 2 diabetes (NIDDM). Two hundred and thirty male type 2 diabetic patients consecutively hospitalized from January to June 1991 were included in the study. The following parameters wer recorded: age, known duration of diabetes, BMI (kg/m2), waist to hip ratio (WHR), HbAlc, triglycerides, total and HDL cholesterol, fasting plasma insulin level (RIA determination), insulin-resistance assessment (fasting insulinemia/fasting glycemia), hypertension (BP > or = 160 and/or 95 mmHg or presence of antihypertensive treatment), parental history and hypertension, modalities of treatment of diabetes. The distribution of fasting insulin concentrations resulted in a skewed curve: mean +/- SD: 16.5 +/- 10.9, median (ranges): 13.0 (9.5-19). Hyperinsulinemia was defined as fasting insulin level > 22 mUI/ml (value corresponding to the last quintile of distribution of insulinemia in this population and to the extreme value of insulinemia in a cohort of 100 control subjects). Sixty five patients were on diet alone, 45 had biguanide alone, 39 had sulfamide alone and 81 had both biguanide and sulfamide medications. The prevalence of hypertension was 44% (n = 102). Patients with hypertension, compared to those without, had significant (p < 0.05) higher values for age, duration of diabetes, BMI, WHR, prevalence of hyperinsulinemia and plasma insulin levels. These two groups were similar as regards HbAlc, insulin resistance assessment, treatment of diabetes and parental history of hypertension. Patients with hyperinsulinemia were younger (p < 0.03), had higher prevalence of hypertension (p < 0.04), higher values for triglycerides (p 0.01) and lower values for HDL cholesterol (p < 0.003) than those without hyperinsulinemia.(ABSTRACT TRUNCATED AT 250 WORDS)