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Related Experiment Videos

Elevated hepatic insulin extraction in essential hypertension

A Kautzky-Willer1, G Pacini, M Weissel

  • 1Second Medical Department, University of Vienna, Austria.

Hypertension (Dallas, Tex. : 1979)
|May 1, 1993
PubMed
Summary

Hypertension is linked to reduced insulin sensitivity and increased insulin extraction by the liver, which partially offsets pancreatic over-secretion. Drug treatment normalized blood pressure but not metabolic changes.

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Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Syndrome

Background:

  • Essential hypertension is frequently associated with insulin resistance, hyperinsulinemia, and dyslipidemia.
  • The precise relationship between vascular and metabolic disturbances in hypertension remains incompletely understood.

Purpose of the Study:

  • To investigate insulin resistance, pancreatic insulin secretion, and hepatic insulin extraction in untreated essential hypertension.
  • To compare these metabolic parameters in hypertensive patients and normotensive controls.
  • To assess the impact of antihypertensive drug treatment on these parameters.

Main Methods:

  • Oral glucose tolerance test and frequently sampled intravenous glucose tolerance test were performed in 16 untreated hypertensive patients and 16 controls.

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  • Metabolic parameters were quantified using the minimal model technique.
  • Patients were reassessed after 12-16 weeks of antihypertensive drug therapy.

    • Main Results:

    • Hypertensive patients displayed significantly reduced tissue insulin sensitivity compared to controls.
    • Basal insulin secretion and prehepatic insulin secretion were significantly elevated in hypertensive individuals.
    • Hepatic insulin extraction was significantly higher in hypertensive patients, partially compensating for increased insulin secretion.

    Conclusions:

    • Elevated hepatic insulin extraction is a characteristic feature of essential hypertension.
    • This increased extraction partially ameliorates pancreatic beta-cell hypersecretion in hypertensive individuals.
    • Antihypertensive treatment normalized blood pressure but did not alter the observed metabolic disturbances.