Feldstein C A, Renauld A, Akopian M, Olivieri A O, Garrido D
Hypertension Program, Buenos Aires University School of Medicine, Argentina.
J Cardiovasc Risk. 1998 Feb;5(1):25-30.
To elucidate the role of hypertension as part of a state of insulin resistance.
Thirty-one uncomplicated hypertensive men not receiving antihypertensive treatment or who had been without treatment for a 4-week washout period and 10 lean normotensive controls were compared. Hypertensive men were divided according to their body mass index into three groups. All subjects came to the clinic for measurements of height, weight, hip and waist circumferences, and sitting blood pressure, and to begin 24 h ambulatory blood pressure monitoring. Plasma glucose and insulin levels were measured during a 2 h oral glucose (75 g)-tolerance test. For the hypertensive population as a whole, behaviors of studied variables among dippers (n = 18) and nondippers (n = 13) were determined.
During oral glucose-tolerance testing blood glucose levels after 60 min and 120 min were significantly higher (P < 0.05) in members of the high body mass index group than they were in members of the low body mass index group. Insulin levels of members of the high and middle body mass index groups were higher than those of members of the low body mass index group after 60 min (P < 0.05 for both comparisons) and 120 min (P < 0.05 for both comparisons). The mean serum insulin level in members of the low body mass index group was significantly higher than that in normotensives after 30 min, 60 min and 120 min (P < 0.05 for all three comparisons). The mean serum insulin: plasma glucose ratio for men in the low BMI group was significantly higher than that for normotensives after 60 min and 120 min (P < 0.05 for both comparisons). Correlations of blood pressure and insulin levels were not significant. Levels of high-density lipoprotein cholesterol and triglycerides were lower in members of the group with high body mass index than they were in members of the group with low body mass index. Total cholesterol: high-density lipoprotein cholesterol ratio was higher for members of the high body mass index group than it was for members of the middle body mass index group. Weight, body mass index, casual systolic blood pressure, 24 h average systolic blood pressure and diastolic blood pressure, 0700-2300 h systolic blood pressure, and 24 h average heart rate-systolic blood pressure product of dippers were significantly lower than those of nondippers.
These results suggest that hypertension and being overweight have additive effects increasing insulinemia and that being overweight is associated with a significantly lower nocturnal fall in blood pressure.
阐明高血压作为胰岛素抵抗状态一部分的作用。
对31名未接受抗高血压治疗或已停药4周洗脱期的单纯性高血压男性和10名体型偏瘦的血压正常对照者进行比较。高血压男性根据其体重指数分为三组。所有受试者均到诊所测量身高、体重、臀围和腰围以及坐位血压，并开始进行24小时动态血压监测。在2小时口服葡萄糖（75克）耐量试验期间测量血浆葡萄糖和胰岛素水平。对于整个高血压人群，确定了勺型血压者（n = 18）和非勺型血压者（n = 13）中研究变量的行为。
在口服葡萄糖耐量试验期间，高体重指数组成员在60分钟和120分钟后的血糖水平显著高于低体重指数组成员（P < 0.05）。高体重指数组和中等体重指数组成员在6分钟（两组比较P均 < 0.05）和120分钟（两组比较P均 < 0.05）后的胰岛素水平高于低体重指数组成员。低体重指数组成员在30分钟、60分钟和120分钟后的平均血清胰岛素水平显著高于血压正常者（三组比较P均 < 0.05）。低体重指数组男性在60分钟和120分钟后的平均血清胰岛素与血浆葡萄糖比值显著高于血压正常者（两组比较P均 <
