Relations between blood insulin concentration, renin-angiotensin-aldosterone system and clinical picture of hypertension
Didenko, V.A.; Simonov, D.V.
Terapevticheskii Arkhiv 71(1): 26-31
1999
ISSN/ISBN: 0040-3660 PMID: 10097296 Document Number: 511112
To analyse relationships between blood insulin concentration, renin-angiotensin-aldosteron system and clinical picture of hypertension. Measurements of insulin, renin, aldosteron, angiotensin I, total cholesterol, HDLP cholesterol and triglycerides in the blood were made in 60 males with essential hypertension. The examination also included echo-CG, glucose tolerance test, Ketle's index estimation. Patients suffering from essential hypertension with borderline hyperinsulinemia (insulin within 5.7-12.7 mcU/ml) were characterized by a combination of blood hypertension with a metabolic disorder (obesity or defects in carbohydrate metabolism), activation of renin-angiotensin-aldosteron system and left ventricular diastolic dysfunction. Patients with essential hypertension and marked hyperinsulinemia (insulin exceeded 12.7 mcU/ml) had manifest metabolic syndrome (hypertension, obesity, disturbance of carbohydrate metabolism and hypertriglyceridemia), hyperactivity of renin-angiotensin-aldosterone system, elevated diastolic arterial pressure, remodelling of left ventricular myocardium with development of its concentric hypertrophy and impairment of the diastolic function. It is suggested that enhanced activity of renin-angiotensin-aldosterone system may underlie development of insulin-resistance and hyperinsulinemia. The latter plays a significant pathogenetic role in forming clinical picture of essential hypertension in insulin levels > 12.7 mcU/ml.