Insulin resistance in offspring of hypertensive parents.

Abstract

Objective-To determine if insulin resistance is present in normotensive adults at increased risk ofdeveloping hypertension.Design-Normotensive subjects with at least one hypertensive parent were paired with offspring of normotensive parents (controls), being matched for age, sex, social class, and physical activity.Setting-Outpatient clinic. Subjects-30 paired subjects (16 men and 14 women) with and without a family history of hypertension, aged 18-32, with a body mass index < 25 kg/mi, with blood pressure < 130/85 mm Hg, and not taking drugs.Interventions-Euglycaemic glucose clamp (two hour infusion of insulin 1 mU/kg/min) and intravenous glucose tolerance test (injection of 100 ml 20% glucose).Main outcome measures-Insulin mediated glucose disposal and insulin secretion.Results-The offspring of hypertensive parents had slightly higher blood pressure than did the controls (mean 117 (SD 6) v 108 (5) mm Hg systolic, p=0013; 76 (7) v 67 (6) mm Hg diastolic, p=0.017). Their insulin mediated glucose disposal was lower than that of controls (29.5 (6 5) v 40-1 (8.6) [imol/kg/min, p=0.002), but, after adjustment for blood pressure, the difference was not significant (difference 6-9 (95% confidence interval -1 5 to 15.3), p=010). Insulin secretion in the first hour after injection of glucose was slightly but not significantly higher in the offspring of hypertensive patients (9320 (5484) Conclusions-Young normotensive subjects who are at increased risk of developing hypertension are insulin resistant.

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

“…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.…”

“…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. 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.…”

The ‘carnivore connection’—evolutionary aspects of insulin resistance

“…Insulin-mediated glucose uptake is reduced by 30 -40% in people with essential hypertension (Ferrannini et al, 1987), an abnormality demonstrated in both non-obese and obese individuals with hypertension (Reaven, 1991) and in young normotensive subjects who are at increased risk of developing hypertension (Beatty et al, 1993). Furthermore, this abnormality continues to be present even after the hypertension has been treated effectively (Reaven, 1991).…”

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.…”