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Abnormalities of Carbohydrate and Lipid Metabolism in Patients With Hypertension

Abnormalities of Carbohydrate and Lipid Metabolism in Patients With Hypertension Abstract • Plasma glucose, insulin, and lipoprotein concentrations were determined in 20 men with hypertension, and compared with values in 20 normotensive men of comparable age and body mass index. The results demonstrated a significant increase in both the plasma glucose and insulin response to a 75-g oral glucose challenge (two-way analysis of variance). In addition, a significant correlation existed between the plasma insulin response to oral glucose and both systolic and diastolic blood pressure. Finally, the greater the plasma glucose and insulin responses to oral glucose, the lower the plasma high-density lipoprotein concentrations, and the higher the ratio of plasma low-density lipoprotein cholesterol to high-density lipoprotein cholesterol. Thus, abnormalities of plasma glucose, insulin, and lipoprotein metabolism exist in patients with untreated hypertension, and these changes may contribute to the increased risk for coronary artery disease associated with hypertension. (Arch Intern Med 1987;147:1035-1038) References 1. Stamler J, Rhomberg P, Schoenberger JA, et al: Multivariate analysis of the relationship of seven variables to blood pressure: Findings of the Chicago Heart Association detection project in industry, 1967-1972. J Chron Dis 1975;28:527-548.Crossref 2. Jarrett RJ, Keen H, McCartney M, et al: Glucose tolerance and blood pressure in two population samples: Their relation to diabetes mellitus and hypertension. Int J Epidemiol 1978;7:15-24.Crossref 3. Persky V, Dyer A, Stamler J, et al: The relationship between postload plasma glucose and blood pressure at different resting heart rates. J Chron Dis 1979;32:263-268.Crossref 4. Voors AW, Radhakrishnamurthy B, Srinavasan SE, et al: Plasma glucose level related to blood pressure in 272 children, aged 7-15 years, sampled from a total biracial population. Am J Epidemiol 1981;113:347-356. 5. Florey C du V, Uppal S, Lowy C: Relation between blood pressure, weight, and plasma sugar and serum insulin levels in schoolchildren aged 9-12 years in Westland, Holland. Br Med J 1976;1:1368-1371.Crossref 6. Modan M, Halkin H, Almog S, et al: Hyperinsulinemia: A link between hypertension obesity and glucose intolerance. J Clin Invest 1985;75:809-817.Crossref 7. Lucas CP, Estrigarribia JA, Darga LL, et al: Insulin and blood pressure in obesity. Hypertension 1985;5:702-706.Crossref 8. Singer P, Godicke W, Voigt S, et al: Postprandial hyperinsulinemia in patients with mild essential hypertension. Hypertension 1984;7:182-186.Crossref 9. Manicardi V, Camellini L, Belodi G, et al: Evidence for an association of high blood pressure and hyperinsulinemia in obese man. J Clin Endocrinol Metab 1986;62:1302-1304.Crossref 10. Goldman AI, Steele BW, Schnaper HW, et al: Serum lipoprotein levels during antihypertensive therapy. JAMA 1980;224:1691-1695.Crossref 11. Ames RP: Metabolic disturbances increasing the risk of coronary heart disease during diuretic-based antihypertensive therapy: Lipid alterations and glucose intolerance. Am Heart J 1983;106:1207-1214.Crossref 12. Leren P: The effect of alpha- and beta-blocker therapy on blood lipids: European experience. Am J Med 1984;76:67-71.Crossref 13. MacMahon SW, Macdonald GJ, Blacket RB: Plasma lipoprotein levels in treated and untreated hypertensive men and women. Arteriosclerosis 1985;5:391-396.Crossref 14. Hales CN, Randle PJ: Immunoassay of insulin with insulin-antibody precipitate. Biochem J 1963;88:137. 15. Kadish AH, Litle RL, Sternberg JC: A new and rapid method for determination of glucose by measurement of rate of oxygen consumption. Clin Chem 1968;14:116-131. 16. Allain CC, Poon LS, Chan CSG, et al: Enzymatic determination of total serum cholesterol. Clin Chem 1975;20:470-475. 17. Wahlfeld AW: Triglyceride determination after enzymatic hydrolysis , in Bergmeyer HV (ed): Methods of Enzymatic Analysis . Orlando, Fla, Academic Press Inc, 1974, p 1831. 18. Havel RJ, Eder HA, Bragdon JH: The distribution of ultracentrifugally separated lipoproteins in human serum. J Clin Invest 1955;34: 1345-1353.Crossref 19. Miller RG Jr: Simultaneous Statistical Inference . New York, Springer-Verlag NY Inc, 1981, vol 1, pp 15-16. 20. Godfrey K: Statistics in practice: Comparing the means of several groups. N Engl J Med 1985;313:1450-1456.Crossref 21. Bancroft H: Introduction to Biostatistics . New York, Paul B Hoeber Inc, 1962, pp 147-157. 22. Reaven GM, Miller R: Study of the relationship between glucose and insulin responses to an oral glucose load in man. Diabetes 1968;17:560-569. 23. Fuller JH, Shipley MJ, Rose G, et al: Coronary-heart-disease risk and impaired glucose tolerance. Lancet 1980;1:1373-1376.Crossref 24. Pyorala K: Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: Results from two population studies in Finland. Diabetes Care 1979;2:131-141.Crossref 25. Ducimetiere P, Eschwege E, Papoz L, et al: Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. Diabetologia 1980;19:205-210.Crossref 26. Welborn TA, Wearne K: Coronary heart disease incidence and cardiovascular mortality in Busselton with reference to glucose and insulin concentrations. Diabetes Care 1979;2:154.Crossref 27. Reaven GM, Lerner RL, Stern MP, et al: Role of insulin in endogenous hypertriglyceridemia. J Clin Invest 1967;46:1756-1767.Crossref 28. Stalder M, Pometta D, Suenram A: Relationship between plasma insulin levels and high-density lipoprotein cholesterol levels in healthy men. Diabetologia 1981;21:544. 29. Zavaroni I, Dall'Aglio E, Alphi O, et al: Evidence for an independent relationship between plasma insulin and concentration of high density lipoprotein cholesterol and triglyceride. Atherosclerosis 1985;55:259-266.Crossref 30. Leren P, Helegeland A, Hjermann I, et al: The Oslo study: CHD risk factors, socioeconomic influences, and intervention. Am Heart J 1983;106: 1200-1206.Crossref 31. Reader R: Report by the management committee: The Australian therapeutic trial in mild hypertension. Lancet 1980;1:1261-1267. 32. Multiple Risk Factor Intervention Trial Research Group: Multiple Risk Factor Intervention Trial: Risk factor changes and mortality results. JAMA 1982;248:1465.Crossref 33. Ralph A, DeFronzo C, Robert C, et al: The effect of insulin on renal handling of sodium potassium, calcium, and phosphate in man. J Clin Invest 1975;55:845-855.Crossref 34. Rowe JW, Young JB, Minaker KL, et al: Effect of insulin and glucose infusions on sympathetic nervous system activity in normal man. Diabetes 1981;30:219.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Abnormalities of Carbohydrate and Lipid Metabolism in Patients With Hypertension

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American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1987.00370060031006
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Abstract

Abstract • Plasma glucose, insulin, and lipoprotein concentrations were determined in 20 men with hypertension, and compared with values in 20 normotensive men of comparable age and body mass index. The results demonstrated a significant increase in both the plasma glucose and insulin response to a 75-g oral glucose challenge (two-way analysis of variance). In addition, a significant correlation existed between the plasma insulin response to oral glucose and both systolic and diastolic blood pressure. Finally, the greater the plasma glucose and insulin responses to oral glucose, the lower the plasma high-density lipoprotein concentrations, and the higher the ratio of plasma low-density lipoprotein cholesterol to high-density lipoprotein cholesterol. Thus, abnormalities of plasma glucose, insulin, and lipoprotein metabolism exist in patients with untreated hypertension, and these changes may contribute to the increased risk for coronary artery disease associated with hypertension. (Arch Intern Med 1987;147:1035-1038) References 1. Stamler J, Rhomberg P, Schoenberger JA, et al: Multivariate analysis of the relationship of seven variables to blood pressure: Findings of the Chicago Heart Association detection project in industry, 1967-1972. J Chron Dis 1975;28:527-548.Crossref 2. Jarrett RJ, Keen H, McCartney M, et al: Glucose tolerance and blood pressure in two population samples: Their relation to diabetes mellitus and hypertension. Int J Epidemiol 1978;7:15-24.Crossref 3. Persky V, Dyer A, Stamler J, et al: The relationship between postload plasma glucose and blood pressure at different resting heart rates. J Chron Dis 1979;32:263-268.Crossref 4. Voors AW, Radhakrishnamurthy B, Srinavasan SE, et al: Plasma glucose level related to blood pressure in 272 children, aged 7-15 years, sampled from a total biracial population. Am J Epidemiol 1981;113:347-356. 5. Florey C du V, Uppal S, Lowy C: Relation between blood pressure, weight, and plasma sugar and serum insulin levels in schoolchildren aged 9-12 years in Westland, Holland. Br Med J 1976;1:1368-1371.Crossref 6. Modan M, Halkin H, Almog S, et al: Hyperinsulinemia: A link between hypertension obesity and glucose intolerance. J Clin Invest 1985;75:809-817.Crossref 7. Lucas CP, Estrigarribia JA, Darga LL, et al: Insulin and blood pressure in obesity. Hypertension 1985;5:702-706.Crossref 8. Singer P, Godicke W, Voigt S, et al: Postprandial hyperinsulinemia in patients with mild essential hypertension. Hypertension 1984;7:182-186.Crossref 9. Manicardi V, Camellini L, Belodi G, et al: Evidence for an association of high blood pressure and hyperinsulinemia in obese man. J Clin Endocrinol Metab 1986;62:1302-1304.Crossref 10. Goldman AI, Steele BW, Schnaper HW, et al: Serum lipoprotein levels during antihypertensive therapy. JAMA 1980;224:1691-1695.Crossref 11. Ames RP: Metabolic disturbances increasing the risk of coronary heart disease during diuretic-based antihypertensive therapy: Lipid alterations and glucose intolerance. Am Heart J 1983;106:1207-1214.Crossref 12. Leren P: The effect of alpha- and beta-blocker therapy on blood lipids: European experience. Am J Med 1984;76:67-71.Crossref 13. MacMahon SW, Macdonald GJ, Blacket RB: Plasma lipoprotein levels in treated and untreated hypertensive men and women. Arteriosclerosis 1985;5:391-396.Crossref 14. Hales CN, Randle PJ: Immunoassay of insulin with insulin-antibody precipitate. Biochem J 1963;88:137. 15. Kadish AH, Litle RL, Sternberg JC: A new and rapid method for determination of glucose by measurement of rate of oxygen consumption. Clin Chem 1968;14:116-131. 16. Allain CC, Poon LS, Chan CSG, et al: Enzymatic determination of total serum cholesterol. Clin Chem 1975;20:470-475. 17. Wahlfeld AW: Triglyceride determination after enzymatic hydrolysis , in Bergmeyer HV (ed): Methods of Enzymatic Analysis . Orlando, Fla, Academic Press Inc, 1974, p 1831. 18. Havel RJ, Eder HA, Bragdon JH: The distribution of ultracentrifugally separated lipoproteins in human serum. J Clin Invest 1955;34: 1345-1353.Crossref 19. Miller RG Jr: Simultaneous Statistical Inference . New York, Springer-Verlag NY Inc, 1981, vol 1, pp 15-16. 20. Godfrey K: Statistics in practice: Comparing the means of several groups. N Engl J Med 1985;313:1450-1456.Crossref 21. Bancroft H: Introduction to Biostatistics . New York, Paul B Hoeber Inc, 1962, pp 147-157. 22. Reaven GM, Miller R: Study of the relationship between glucose and insulin responses to an oral glucose load in man. Diabetes 1968;17:560-569. 23. Fuller JH, Shipley MJ, Rose G, et al: Coronary-heart-disease risk and impaired glucose tolerance. Lancet 1980;1:1373-1376.Crossref 24. Pyorala K: Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: Results from two population studies in Finland. Diabetes Care 1979;2:131-141.Crossref 25. Ducimetiere P, Eschwege E, Papoz L, et al: Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. Diabetologia 1980;19:205-210.Crossref 26. Welborn TA, Wearne K: Coronary heart disease incidence and cardiovascular mortality in Busselton with reference to glucose and insulin concentrations. Diabetes Care 1979;2:154.Crossref 27. Reaven GM, Lerner RL, Stern MP, et al: Role of insulin in endogenous hypertriglyceridemia. J Clin Invest 1967;46:1756-1767.Crossref 28. Stalder M, Pometta D, Suenram A: Relationship between plasma insulin levels and high-density lipoprotein cholesterol levels in healthy men. Diabetologia 1981;21:544. 29. Zavaroni I, Dall'Aglio E, Alphi O, et al: Evidence for an independent relationship between plasma insulin and concentration of high density lipoprotein cholesterol and triglyceride. Atherosclerosis 1985;55:259-266.Crossref 30. Leren P, Helegeland A, Hjermann I, et al: The Oslo study: CHD risk factors, socioeconomic influences, and intervention. Am Heart J 1983;106: 1200-1206.Crossref 31. Reader R: Report by the management committee: The Australian therapeutic trial in mild hypertension. Lancet 1980;1:1261-1267. 32. Multiple Risk Factor Intervention Trial Research Group: Multiple Risk Factor Intervention Trial: Risk factor changes and mortality results. JAMA 1982;248:1465.Crossref 33. Ralph A, DeFronzo C, Robert C, et al: The effect of insulin on renal handling of sodium potassium, calcium, and phosphate in man. J Clin Invest 1975;55:845-855.Crossref 34. Rowe JW, Young JB, Minaker KL, et al: Effect of insulin and glucose infusions on sympathetic nervous system activity in normal man. Diabetes 1981;30:219.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1987

References