Prevalence of hyperinsulinaemia in patients with high blood pressure

Abstract

A total of 41 patients with hypertension were identified in a survey of 732 healthy factory workers. Twenty-three of these individuals were receiving antihypertensive medication, whereas 18 cases were newly discovered. Plasma glucose and insulin responses to oral glucose and fasting plasma triglyceride (TG), cholesterol, and high-density-lipoprotein (HDL) cholesterol concentrations of these 41 individuals were compared with those of 41 other factor workers, with normal blood pressure, matched with the hypertensive group in terms of gender, age, degree of obesity, job in the factory, and leisure-time activity. Patients with hypertension had significantly higher plasma glucose (P less than 0.05) and insulin (P less than 0.05) concentrations in response to oral glucose, as well as a higher plasma TG concentration (P less than 0.05). Similar findings were obtained when the treated and untreated hypertensive groups were analysed separately and compared with their respective control groups. However, there were no differences between the treated and untreated hypertensive groups. Ninety per cent of the normotensive group had a plasma insulin concentration of less than 500 pmol l-1 2 h after the glucose load. Using this value as the criterion for definition of hyperinsulinaemia, 41% of the patients with high blood pressure were hyperinsulinaemic. In addition to meeting this cut-off point, the patients with hypertension and hyperinsulinaemia were also glucose intolerant and dyslipidaemic. In conclusion, approximately 50% of an unselected group of patients with hypertension were hyperinsulinaemic. Insulin levels were comparable in treated and untreated patients with high blood pressure, and hyperinsulinaemic patients also tended to be glucose intolerant and dyslipidaemic.

The metabolic syndrome entanglement: cutting the Gordian knot

“…These data provide substantial support for the theory that insulin resistance/hyperinsulinemia plays a role in the pathogenesis of essential hypertension [9]. On the other hand, probably no more than 50% of patients with essential hypertension are insulin resistant [21]. However, it is only this subset of patients that display the components of the various definitions of MS that render them at greatest risk for CVD [9].…”

Relationship to Insulin Resistance of the Adult Treatment Panel III Diagnostic Criteria for Identification of the Metabolic Syndrome

“…Perhaps the best example of this apparent paradox involves the relationship between insulin resistance, hypertension, and CVD. No more than 50% of patients with essential hypertension are insulin resistant (37), and the results in Table 5 indicate that Ͻ20% of the variance in SSPG can be attributed to differences in blood pressure. Furthermore, Table 5 also indicates that differences in plasma triglyceride concentration can account for no more than 40% of the variance in SSPG concentration.…”

Effect of metabolic syndrome or type II diabetes mellitus on the occurrence of recurrent vascular events in hypertensive patients

“…1,2 In about half of patients with hypertension insulin resistance can be found and hypertension tends to cluster with metabolic risk factors. 3,4 Therefore, hypertension is considered one of the key features of the metabolic syndrome. 5,6 The clustering of cardiovascular risk factors, often referred to as metabolic syndrome, is closely associated with central obesity and insulin resistance.…”