Mechanisms of hypertension in the overweight.

Sims, Ethan A. H.

doi:10.1161/01.hyp.4.5_pt_2.iii43

Cited by 29 publications

(24 citation statements)

References 41 publications

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“…27 But the biological plausibility of insulin as a hypertensive agent seems slender. 28 An independent association of obesity and weight gain with hypertension has been observed in many cross-sectional and prospective studies, [29][30][31] and several studies have shown that body fat distribution is a more powerful determinant of BP than overall measures of obesity, 32,33 In this study, the increased BMI preceded the development of hypertension, and correlated positively with the fasting insulin concentration (r = 0.54, P Ͻ 0.001). This may suggest that hyperinsulinaemia is a link between hypertension and obesity and that the association of hypertension with obesity is mediated by hyperinsulinaemia.…”

Section: Discussionsupporting

confidence: 59%

Hypertension, hyperinsulinaemia and obesity in middle-aged Finns with impaired glucose tolerance

Qiao

Rajala

Keinänen‐Kiukaanniemi

1998

J Hum Hypertens

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The aim of the study was to analyse the data obtained from a 2-year follow-up study of middle-aged Finnish subjects (n = 183) with a previous history of impaired glucose tolerance (IGT) in order to elucidate the longitudinal relationships between hypertension, fasting hyperinsulinaemia and obesity. Hypertension was defined as either a systolic blood pressure (BP) of у160 mm Hg or a diastolic BP of у95 mm Hg or being on antihypertensive medication regardless of the BP value. Multiple logistic regression analysis adjusted for glucose tolerance status, serum lipids, exercise behaviour and alcohol consumption shows that the odds ratios of

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Section: Discussionsupporting

confidence: 59%

Hypertension, hyperinsulinaemia and obesity in middle-aged Finns with impaired glucose tolerance

Qiao

Rajala

Keinänen‐Kiukaanniemi

1998

J Hum Hypertens

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“…31 Obese persons are known to have increased levels of insulin and norepinephrine. 3 Simultaneous measurements of insulin and norepinephrine are needed to strengthen this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

“…3 •* This viewpoint is bolstered by observations that short-term insulin administration to normal subjects results in sodium retention, 5 -6 as well as increased blood pressure and heart rate. 7 The present study examines the relation of age, weight, sodium intake, serum glucose level, and serum insulin level to blood pressure in markedly obese subjects.…”

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confidence: 99%

Insulin and blood pressure in obesity.

Lucas¹,

Estigarribia²,

Darga³

et al. 1985

Hypertension

254

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SUMMARY To assess factors in overweight persons that account for a tendency toward hypertension, 33 very obese women, 26 to 77 years of age, were studied. Blood pressures in these 33 women varied from low normal to mildly hypertensive. None of them had taken medication for high blood pressure, and none had diabetes mellitus. The effect of independent variables -age, body mass index (weight/height 2 ), fasting serum glucose levels, fasting serum insulin levels, and 24-hour urinary sodium excretion -on systolic and diastolic blood pressure was assessed. There was no correlation between sodium excretion and blood pressure. Age did not correlate with diastolic blood pressure but did correlate with systolic blood pressure when body mass index, serum glucose level, and insulin level were controlled. Diastolic blood pressure correlated with body mass index and serum glucose level, but only the latter remained significant when all independent variables were considered together. Both systolic and diastolic blood pressure were found to be significantly related to fasting serum insulin level (r = 0.47, p = 0.005 and r = 0.68, p < 0.001) even when age, weight, and serum glucose level were controlled (r = 0.41, p = 0.025 and r = 0.62, p < 0.001 respectively). The relation between serum insulin and blood pressure was more pronounced in those women with a family history of hypertension. These data indicate that insulin may play a major role in the regulation of blood pressure in obesity and that the previously accepted relation of weight to blood pressure may depend on blood levels of insulin. (Hypertension 7: 702-706, 1985) KEY WORDS • obesity • blood pressure • insulin • sodium excretion O BESITY is often associated with elevated blood pressure.1 ' 2 One of the factors thought to be responsible for this tendency toward hypertension is the often-observed hyperinsulinemia of obese subjects. 3•* This viewpoint is bolstered by observations that short-term insulin administration to normal subjects results in sodium retention, 5 -6 as well as increased blood pressure and heart rate. The present study examines the relation of age, weight, sodium intake, serum glucose level, and serum insulin level to blood pressure in markedly obese subjects. The results from this cross-sectional analysis indicate that obese persons with higher blood pressure tend to have the highest serum insulin levels and that this association is independent of age, weight, and serum glucose level.Subjects and Methods Thirty-three obese women, ranging in age from 26 to 77 years, who were at least 33% above calculated ideal weight, were studied in the Wayne State Univer-

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“…Sympathetic hyperactivity (4-10) and hyperinsulinemia (11)(12)(13)(14)(15)(16)(17)(18) appear to be to some extent responsible for this tendency towards hypertension or blood pressure elevation in obese subjects. Regarding the heightened sympathetic nervous system activity in the obese, 1) we have previously reported that the higher levels of plasma norepinephrine (NE), insulin and leptin can be observed in obese subjects regardless of BP status in weight-reduction studies (10).…”

Section: Introductionmentioning

confidence: 99%

Sympathetic Activity and Body Mass Index Contribute to Blood Pressure Levels.

et al. 2000

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Toshio 0 GIHARA, The purpose of this study was to clarify the relationships between obesity (BMI) and BP levels, leptin levels, sympathetic activity, and insulin sensitivity in a Japanese male population. In 912 young, non-diabetic, Japanese men with a wide range of BMI (16.5-33.6 kg/m2), blood pressure (BP), fasting plasma norepinephrine (NE), insulin and leptin levels were measured after an overnight fast. The cohort consisted of 603 normotensive and 309 hypertensive subjects. The study was carried out using a cross-sectional design. . When the subjects were subdivided by tertile in relation to BMI, the 101 subjects in the heaviest group (BMI > 27.9 kg/m2) had a significantly higher systolic BP (p< 0.05) and pulse rate (p< 0.05) as well as higher NE (p< 0.01), insulin (p< 0.01), and leptin (p< 0.01) levels than 86 subjects in the leanest group (BMI < 22.2 kg/m2). In the whole cohort, BMI correlated with mean BP (p< 0.01), plasma NE (p< 0.05), insulin (p<0.001) and leptin (p<0.001).The mean BP correlated with BMI (p<0.001), plasma NE (p<0.01), insulin (p<0.01) and leptin (p<0.05).Plasma leptin levels correlated with fasting plasma insulin levels (p < 0.05), but not with plasma NE levels (NS). As analyzed by multiple regression analysis, only plasma NE (p<0.05) and BMI (p<0.001), but not plasma insulin levels, were significant, independent predictors of BP levels (r2= 0.125, F=10.51, p= 0.0001). These results suggest that obesity (BMI) and heightened sympathetic nervous system activity contribute to BP elevation (hypertension). (Hypertens Res 2000; 23: 303-310)

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Mechanisms of hypertension in the overweight.

Cited by 29 publications

References 41 publications

Hypertension, hyperinsulinaemia and obesity in middle-aged Finns with impaired glucose tolerance

Hypertension, hyperinsulinaemia and obesity in middle-aged Finns with impaired glucose tolerance

Insulin and blood pressure in obesity.

Sympathetic Activity and Body Mass Index Contribute to Blood Pressure Levels.

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