To determine the effects of insulin on intracellular calcium and platelet aggregatory responses in hypertensive subjects with insulin resistance, we measured insulin sensitivity in terms of glucose disposal rate (GDR) by the hyperinsulinemic euglycemic clamp technique (GC) in 14 non-diabetic untreated hypertensive subjects, and determined basal ([Ca2+] The association between hypertension and insulin resistance is well recognized (1). Possible mechanisms by which insulin participates in the pathogenesis of hypertension include increased sodium reabsorption in the kidney (2, 3), activation of the sympathetic nervous system (4), and proliferation of vascular smooth muscle cells (5, 6). On the other hand, evidence against an association between hypertension and insulin resistance includes the following findings: hypertension is not observed in patients with insulinoma despite the presence of hyperinsulinemia (7), continuous infusion of highdose insulin for 7 days does not increase blood pressure in dogs (8), and acute increases in plasma insulin within the physiological range increase sympathetic neural outflow but produce forearm vasodilatation and do not elevate arterial pressure in humans (9) . Insulin has dual pressor and depressor (vasodilatory) effects (10). Also, insulin attenuates both agonist-stimulated vasoconstriction (I1) and aggregatory response of platelets (12, 13).If the vasodilatory and antiaggregatory effects of insulin were impaired in hypertensive subjects with insulin resistance, an association between hypertension and insulin resistance would be supported. We therefore measured insulin sensitivity in peripheral glucose utilization as determined by glucose clamp, intracellular calcium concentration in platelets as a marker of the vasodilatory effect of insulin on vascular smooth muscle cells, and platelet aggregation before and during glucose clamp, and examined the relationship between insulin resistance and the effects of insulin on intracellular calcium concentration and platelet aggregation in hypertensive subjects.
MethodsThe subjects were 14 men with non-diabetic untreated essential hypertension. Insulin sensitivity in terms of glucose disposal rate (GDR) was determined by an artificial endocrine pancreas using the hyperinsulinemic euglycemic clamp technique (GC). Venous blood was drawn from subjects to measureFrom the * 1Department