Kamide K, Rakugi H, Nagano M, Nakano N, Ohishi M, Higaki J, Ogihara T
Department of Geriatric Medicine, Osaka University Medical School, Suita, Japan.
Hypertens Res. 1997 Jun;20(2):127-32. doi: 10.1291/hypres.20.127.
Hyperinsulinemia or insulin resistance is suggested to play a role in the pathogenesis of hypertension and its target organ diseases. It is also well documented that aging is associated with a decline in glucose tolerance and insulin sensitivity, but there are few reports on the relationship between aging and insulin sensitivity or on the effects of aging on the progression of cardiovascular complications in patients with essential hypertension. To clarify these effects of aging in essential hypertension, 44 patients were examined by the euglycemic hyperinsulinemic glucose clamp test and ultrasonography of the heart and carotid arteries. There was a significant negative correlation between aging and insulin sensitivity (r = -0.37, p < 0.05). Significant increases in left ventricular mass index and carotid wall thickening accompanied by insulin resistance were seen in only non-elderly patients but not in elderly patients. These results suggest that aging decreases insulin sensitivity even in essential hypertensive subjects and that insulin resistance does not affect the progression of cardiac hypertrophy and atherosclerosis in elderly patients with essential hypertension.
高胰岛素血症或胰岛素抵抗被认为在高血压及其靶器官疾病的发病机制中起作用。也有充分的文献记载，衰老与糖耐量和胰岛素敏感性下降有关，但关于衰老与胰岛素敏感性之间的关系，或衰老对原发性高血压患者心血管并发症进展的影响的报道很少。为了阐明衰老在原发性高血压中的这些影响，对44例患者进行了正常血糖高胰岛素葡萄糖钳夹试验以及心脏和颈动脉超声检查。衰老与胰岛素敏感性之间存在显著负相关（r = -0.37，p < 0.05）。仅在非老年患者中观察到左心室质量指数显著增加和颈动脉壁增厚伴胰岛素抵抗，而老年患者未观察到。这些结果表明，即使在原发性高血压患者中，衰老也会降低胰岛素敏感性，并且胰岛素抵抗不会影响老年原发性高血压患者心脏肥大和动脉粥样硬化的进展。
