Insulin Resistance, Hyperinsulinemia, and Dyslipidemia in Nonobese Individuals With a Family History of Hypertension

Abstract

Various facets of glucose, insulin, and lipid metabolism were compared in 76 normal volunteers--38 with and 38 without a family history of hypertension. The two groups were comparable in terms of age, gender distribution, and degree of obesity (both generalized and abdominal). Although the plasma glucose response to oral glucose was similar in both groups, glucose-stimulated insulin concentrations were significantly greater in volunteers with a family history of hypertension (P < .001). Furthermore, the steady state plasma glucose concentration during a constant infusion of glucose, insulin and somatostatin was significantly greater in subjects with a family history of hypertension (8.1 +/- 0.6 v 6.2 +/- 0.6 mmol/L, P < .001). Since the steady-state plasma insulin levels during the infusion were similar, these results indicate that normotensive individuals with a family history of hypertension are relatively insulin resistant. Finally, plasma very low density lipoprotein (VLDL) triglyceride and VLDL cholesterol were higher in those with a family history of hypertension, as was the ratio of total to high density lipoprotein cholesterol. Thus, normotensive individuals with a family history of high blood pressure are insulin resistant, hyperinsulinemic and dyslipidemic when compared to a matched group of healthy volunteers without a family history of hypertension.

Haemodynamic, metabolic and neuro-humoral abnormalities in young normotensive women at high familial risk for hypertension

“…29 Previous studies have shown that early stages of both insulin and lipid metabolism alterations are present in young normotensive offspring of hypertensive parents that are matched for gender, age and BMI but not for BP levels. 7,19,24,25,28 This study showed that these early insulin and metabolism alterations also occur in young normotensive female offsprings of hypertensive parents before any increase in BP levels.…”

“…Because of the small sample size, the higher low-density lipoprotein-cholesterol levels observed in FH þ þ group, as well as observed in the FH þ group (B18 mg 100 ml À1 ), cannot be dismissed because of the absence of statistical significance, and may have important clinical relevance. Higher low-density lipoprotein-cholesterol levels among normotensive offsprings of hypertensive parents compared with normotensive with normotensive parents have been shown by some investigators, 7,19,24,25,28 although negative finds exist. 18,26 Abnormalities in lipids, glucose and insulin metabolism have been found to be part of a complex of cardiovascular risk factors commonly found in hypertensive subjects.…”

“…The existence of early abnormalities of glucose and insulin metabolism among offsprings of hypertensive parents has been confirmed by some investigators, 7,19,[24][25][26] although not by all. 15,27 Previous studies have shown elevated fasting insulin and insulin-to- Early abnormalities in family hypertension EG Ciolac et al glucose levels, as well as reduced sensitivity of insulin-mediated cellular glucose disposal, in normotensive offspring of hypertensive parents; however, data have not been analysed separately by neither gender nor parental burden.…”

“…15,27 Previous studies have shown elevated fasting insulin and insulin-to- Early abnormalities in family hypertension EG Ciolac et al glucose levels, as well as reduced sensitivity of insulin-mediated cellular glucose disposal, in normotensive offspring of hypertensive parents; however, data have not been analysed separately by neither gender nor parental burden. 7,[24][25][26] The only study we have known that assayed fasting insulin and insulin resistance in normotensive with three different parental hypertension burden showed that normotensive offspring of two hypertensive parents had elevated plasma insulin levels and were more likely to show greater insulin resistance than normotensive individuals having either one hypertensive parent or normotensive parents; however, the data were also not analysed separately by gender. 19 This study demonstrated that insulin and insulin-toglucose ratio (a marker of insulin resistance) were higher in both women with two or one hypertensive parents than in women with normotensive parents, when a population of young normotensive women matched for age, menstrual cycle phase, BMI and BP levels were analysed.…”

Insulin sensitivity with respect to glucose metabolism in hypertension-prone men did not predict the blood pressure increase in 5 years

“…[3][4][5][6][7] This might indicate that insulin resistance precedes the rise in blood pressure. However, to our knowledge no prospective study has demonstrated the predictive value of insulin resistance with respect to glucose metabolism for the development of hypertension.…”