Kitamura S, Seto S, Nagao S, Matsuo K, Akahoshi M, Yano K
Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Hypertension. 1994 Jan;23(1 Suppl):I16-9. doi: 10.1161/01.hyp.23.1_suppl.i16.
To evaluate the effect of chronic hyperinsulinemia on blood pressure in salt-dependent hypertension, we infused insulin (1.0 IU/d, n = 15) or saline (n = 13) for 4 weeks into deoxycorticosterone acetate-salt hypertensive rats. The insulin infusion increased plasma insulin levels to 24 +/- 2 microU/mL, which was higher than in the saline-infused rats (9 +/- 1 microU/mL) but was still within the physiological range. Blood pressure was measured by the tail-cuff method twice a week, and daily sodium intake and urinary sodium excretion were calculated for 3 weeks. At week 4, arterial pressor responsiveness to norepinephrine, angiotensin II, and hexamethonium bromide was evaluated. After 14 days of chronic infusion, the insulin group showed a higher blood pressure than the saline group (on 21st day: 178 +/- 6 versus 156 +/- 5 mm Hg, P < .05 by tail-cuff method; 171 +/- 4 versus 149 +/- 3 mm Hg, P < .05 by direct intra-arterial measurement). This blood pressure difference was eliminated after ganglionic blockade with hexamethonium bromide (86 +/- 4 mm Hg in insulin-treated and 89 +/- 4 mm Hg in saline-treated rats by direct intra-arterial measurement). Throughout the experiment, neither sodium balance nor arterial pressor responsiveness to norepinephrine or angiotensin II differed between the two groups. In conclusion, chronic hyperinsulinemia in the physiological range augments the development of hypertension in salt-dependent hypertension, and this augmentation may be mediated by sympathetic stimulation independent of salt retention.
为评估慢性高胰岛素血症对盐依赖性高血压患者血压的影响,我们将胰岛素(1.0 IU/d,n = 15)或生理盐水(n = 13)注入醋酸脱氧皮质酮 - 盐高血压大鼠体内,持续4周。胰岛素输注使血浆胰岛素水平升高至24±2 μU/mL,高于输注生理盐水的大鼠(9±1 μU/mL),但仍在生理范围内。每周用尾套法测量两次血压,并计算3周内的每日钠摄入量和尿钠排泄量。在第4周时,评估动脉对去甲肾上腺素、血管紧张素II和溴化六甲铵的升压反应性。慢性输注14天后,胰岛素组的血压高于生理盐水组(第21天:尾套法测量为178±6 vs 156±5 mmHg,P <.05;直接动脉内测量为171±4 vs 149±3 mmHg,P <.05)。用溴化六甲铵进行神经节阻断后,这种血压差异消失(直接动脉内测量,胰岛素治疗组大鼠为86±4 mmHg,生理盐水治疗组大鼠为89±4 mmHg)。在整个实验过程中,两组之间的钠平衡以及动脉对去甲肾上腺素或血管紧张素II的升压反应性均无差异。总之,生理范围内的慢性高胰岛素血症会加剧盐依赖性高血压的发展,这种加剧可能是由交感神经刺激介导的,与钠潴留无关。