Essential hypertension is associated with decreased insulin clearance and insulin resistance

Dan Lender, Carlos Arauz-Pacheco, Beverley A Huet, Philip Raskin

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Essential hypertension is associated with multiple metabolic abnormalities, among them, hyperinsulinemia. This hyperinsulinemia is attributed to the presence of decreased insulin sensitivity (insulin resistance) with consequent compensatory insulin secretion. We tested the hypothesis that decreased insulin clearance is present in hypertensive subjects and contributes to hyperinsulinemia independently of the degree of insulin resistance. Seventy-five subjects were studied (48 hypertensive and 27 normotensive). Both groups were comparable in terms of age, body fat content, waist-to-hip ratio, and sex distribution. A primed continuous insulin infusion at 40 mU/m2 per minute was performed. Glucose was maintained at baseline levels with the euglycemic clamp technique. Hypertensive subjects were characterized by decreased insulin sensitivity (insulin-mediated glucose uptake: 5.14±0.28 versus 7.26±0.61 mg glucose/kg fat-free mass per minute, hypertensive versus normotensive, P=.002), increased insulin levels during the insulin infusions (804±36 versus 510±38 pmol/L, hypertensive versus normotensive, P<.001), and decreased insulin metabolic clearance rate (328±15 versus 521±30 mL/min per meter squared, hypertensive versus normotensive, P<.001). In an ANCOVA (including sex, degree of obesity, waist-to-hip ratio, and insulin sensitivity as covariates) the differences in insulin metabolic clearance rate between normotensive and hypertensive subjects remained highly significant (P<.001). Insulin metabolic clearance rate was significantly associated with fasting insulin levels. We conclude that essential hypertension is independently associated with decreased insulin metabolic clearance rate in addition to insulin resistance. A low insulin metabolic clearance rate may be a contributory factor to the hyperinsulinemia observed in essential hypertension.

Original languageEnglish (US)
Pages (from-to)111-114
Number of pages4
JournalHypertension
Volume29
Issue number1 I
StatePublished - Jan 1997

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Insulin Resistance
Insulin
Metabolic Clearance Rate
Hyperinsulinism
Waist-Hip Ratio
Glucose
Essential Hypertension
Multiple Abnormalities
Sex Distribution
Glucose Clamp Technique
Adipose Tissue
Fasting
Obesity
Fats

Keywords

  • glucose clamp technique
  • hypertension, essential
  • insulin
  • insulin resistance

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Essential hypertension is associated with decreased insulin clearance and insulin resistance. / Lender, Dan; Arauz-Pacheco, Carlos; Huet, Beverley A; Raskin, Philip.

In: Hypertension, Vol. 29, No. 1 I, 01.1997, p. 111-114.

Research output: Contribution to journalArticle

Lender, D, Arauz-Pacheco, C, Huet, BA & Raskin, P 1997, 'Essential hypertension is associated with decreased insulin clearance and insulin resistance', Hypertension, vol. 29, no. 1 I, pp. 111-114.
Lender, Dan ; Arauz-Pacheco, Carlos ; Huet, Beverley A ; Raskin, Philip. / Essential hypertension is associated with decreased insulin clearance and insulin resistance. In: Hypertension. 1997 ; Vol. 29, No. 1 I. pp. 111-114.
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