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Hypertension and CHD: evidence of glucose and lipid metabolism involvement
G Clemenzia1, A Amoroso, G Gubitosi
1Department of Medicina Clinica, University of Rome La Sapienza, Italy.
Insights
Essential hypertension patients show higher glucose and insulin levels. Abnormal electrocardiograms (ECGs) in hypertensive individuals correlate with adverse lipid profiles and increased insulin response.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Syndrome
Background:
- Essential hypertension is a prevalent cardiovascular risk factor.
- Electrocardiogram (ECG) abnormalities are common in hypertensive patients.
- Metabolic disturbances are increasingly recognized in hypertension.
Purpose of the Study:
- To investigate the relationship between essential hypertension, ECG findings, and metabolic parameters.
- To compare glucose and insulin concentrations in hypertensive patients versus controls.
- To identify specific metabolic markers associated with abnormal ECGs in hypertension.
Main Methods:
- Study included 370 patients with moderate to severe essential hypertension and 45 age- and sex-matched controls.
- Oral glucose tolerance tests were performed to measure glucose and insulin levels.
- Electrocardiograms (ECGs) were analyzed for abnormalities, including T wave changes, Q-S segment changes, left bundle branch block, and left ventricular hypertrophy.
- Plasma lipid profiles (triglycerides, total cholesterol, LDL, HDL) were assessed.
Main Results:
- Hypertensive patients exhibited higher fasting and post-glucose glucose and insulin concentrations compared to controls.
- Patients with abnormal ECGs showed significantly higher plasma insulin response post-glucose intake.
- Abnormal ECG findings were associated with elevated triglyceride, total cholesterol, and LDL cholesterol levels.
- A significant increase in the total cholesterol/HDL cholesterol ratio was observed in hypertensive patients with abnormal ECGs.
Conclusions:
- Essential hypertension is linked to impaired glucose-insulin metabolism.
- Abnormal ECG findings in hypertensive individuals are associated with a dyslipidemic profile and heightened insulin resistance.
- These metabolic alterations may contribute to increased cardiovascular risk in hypertensive patients with ECG abnormalities.
Abstract:
Three hundred and seventy subjects (217 women and 153 men) affected by essential hypertension of moderate or severe degree were studied. Their age ranged from 28 to 57 years, with a mean of 47 years. 251 patients had a normal electrocardiogram (ECG) and 119 patients an abnormal ECG: 78 with T wave abnormalities, 4 with Q-S segment abnormalities, 9 with left bundle branch block and 28 with left ventricular hypertrophy. Control group was composed by 45 non hypertensive subjects matched for age and sex. Glucose and insulin concentrations, before and after the oral glucose intake, were higher in patients with essential hypertension than in control group. The hypertensive patients with abnormal ECG were found to have higher plasma insulin response, high triglyceride plasma levels, total cholesterol and LDL cholesterol concentrations, associated with a significant increase in the total cholesterol/HDL cholesterol ratio.