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Metabolic derangements in nonmodulating hypertension
C L Gaboury1, N K Hollenberg, P N Hopkins
1Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
American Journal of Hypertension
|September 1, 1995
Summary
Salt-sensitive hypertension nonmodulators (NM) exhibit higher fasting insulin levels, indicating insulin resistance. This insulin resistance is dissociable from other metabolic factors in hypertensive individuals.
Area of Science:
- Nephrology
- Endocrinology
- Cardiovascular Medicine
Background:
- Insulin resistance, dyslipidemia, and hypertension are interconnected.
- Salt-sensitive hypertension involves impaired sodium regulation.
- A subgroup of salt-sensitive hypertensives, nonmodulators (NM), cannot modulate adrenal and renal blood flow with dietary sodium changes.
Purpose of the Study:
- To investigate if nonmodulators (NM) are insulin resistant and dyslipidemic compared to modulators (M).
- To assess metabolic profiles in hypertensive individuals based on sodium modulation capacity.
Main Methods:
- Evaluated 46 non-diabetic hypertensive individuals.
- Defined modulation status (NM vs. M) using renal or adrenal criteria.
- Measured fasting metabolic factors, including insulin, glucose, lipids, and electrolytes.
- Subdivided NM group by body mass index (BMI) to match M group.
Main Results:
- Nonmodulators (NM) exhibited significantly higher fasting insulin levels compared to modulators (M) (P = .013).
- Lean NM subgroup also showed elevated fasting insulin compared to M (P = .04).
- No significant differences were found in age, blood pressure, glucose, triglycerides, total cholesterol, or potassium levels between groups.
Conclusions:
- Elevated fasting insulin in NM suggests an insulin-resistant state.
- Insulin resistance in hypertensive populations is dissociable from other metabolic derangements.
- Sodium modulation capacity may be linked to insulin sensitivity in hypertension.