Plasma insulin, plasminogen activator inhibitor, and ankle-brachial systolic blood pressure ratio in overweight hypertensive subjects

Abstract

Background: In hypertensive subjects, the ratio between ankle and brachial systolic blood pressure (ABI) has been shown to be an independent risk factor for cardiovascular diseases, particularly in the elderly. Plasma insulin may be an important interconnecting factor explaining this observation. Purpose: In a population of middle-aged subjects with essential hypertension and moderate overweight, we identified whether the decrease in the ABI ratio was associated with the clinical and biochemical factors involved in resistance to insulin. Patients with diabetes and/or arteriosclerosis obliterans of the lower limbs were excluded from the population. Subjects were or were not on antihypertensive therapy. Result: On the basis of univariate correlations, the ABI ratio was found to be significantly and negatively associated not only with the degree of abdominal fat distri-

Central obesity is associated with reduced peripheral wave reflection in Indigenous Australians irrespective of diabetes status

“…Insulinresistant obese [31] and type 2 diabetic individuals [32] have an impaired response. In a middle-aged hypertensive population, insulin and plasminogen activator inhibitor were negatively associated with the ankle-brachial pressure index [33]. There are thus inconsistencies in findings on the relationship between fasting insulin and arterial stiffness, which could be explained by the differences in technique used and population studied.…”

Peripheral arterial disease and isolated systolic hypertension: The ATTEST Study

“…Sodium excess and b-blocking agents may increase SBP through increase in arterial stiffness and disturbed wave reflections, whereas nitrates and angiotensin-converting enzyme inhibitors (ACEI) have an opposite effect. 12,[16][17][18] Third, stenoses of renal artery are relatively frequent in subjects with PAD and favour the presence of systolic-diastolic hypertension. 19 Finally, clinical studies have shown that increased arterial stiffness and disturbed wave reflections are not only frequent in subjects with PAD but also are significantly associated with reduced walking distance and impaired vasodilating arteriolar properties.…”

Age‐related increase of pulse pressure and plasminogen activator inhibitor‐1 I/D gene polymorphism in essential hypertension

“…This observation is consistent with previous investigations in the past where we showed subtle but consistent statistical links between plasma PAI‐1, arterial stiffness and wave reflections, the two latter factors being the main determinants of PP. Indeed, elevated plasma PAI‐1 levels are significantly associated with reduced carotid distensibility and/or altered PP amplification, both in subjects with hypertension and overweight and in patients with chronic renal disease [43–45].…”