This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sung, B. H. Articles by Dandona, P. Search for Related Content PubMed PubMed Citation Articles by Sung, B. H. Articles by Dandona, P.

(Hypertension. 1997;30:848-853.)
© 1997 American Heart Association, Inc.

Articles

Moderately Obese, Insulin-Resistant Women Exhibit Abnormal Vascular Reactivity to Stress

Bong Hee Sung; Michael F. Wilson; Joseph L. Izzo, Jr; Lalaine Ramirez; ; Paresh Dandona

From the Department of Medicine, State University of New York, and Millard Fillmore Health System, Buffalo, NY.

Correspondence to Bong Hee Sung, PhD, Department of Medicine, Millard Fillmore Hospital, 3 Gates Circle, Buffalo, NY 14209. E-mail bsung{at}mfhs.edu

Abstract To define the hemodynamic implications of insulin resistance (IR), we compared 10 normotensive, insulin-resistant women who had abnormal glucose tolerance tests with 10 age-matched healthy normotensive women with normal glucose tolerance tests with respect to mental arithmetic and handgrip responses. Hemodynamic variables obtained at baseline and during stress included heart rate, blood pressure, cardiac output, and systemic vascular resistance. The IR group weighed more (84 versus 66 kg). Screening BP was similar (123/72 versus 120/68 mm Hg, P=NS) between groups although baseline diastolic BP at testing day was higher in the IR group than control group (75 versus 65 mm Hg, P<.05). The IR group showed a significantly greater increase in systolic (18% versus 10%, P<.01) and diastolic (24% versus 12%, P<.01) blood pressure responses to mental stress than the control group. During mental stress, the control group demonstrated increased cardiac output (1.4 L/min) and decreased systemic vascular resistance (-120 dyne · s · cm^-5), whereas IR subjects demonstrated increased systemic vascular resistance (119 dyne · s · cm^-5; group difference, P<.02) with only a small increase in cardiac output (0.5 L/min). Handgrip also caused a greater increase in systemic vascular resistance in the IR group (252 versus 64 dyne · s · cm^-5, P<.05), with a correspondingly greater increase in blood pressure than control subjects. Baseline blood pressure was correlated with weight (r=.41, P<.02) and stress blood pressure with fasting insulin (r=.51, P<.001) and glucose-to-insulin ratio (r=-.55, P<.001). We conclude that insulin resistance is associated with an exaggerated blood pressure response to stress; an enhanced vasoconstriction to stress may mediate this response. This hyperreactivity may be a marker for future hypertension in obese, normotensive, hyperinsulinemic individuals.

Key Words: insulin resistance • vascular resistance • blood pressure • stress

This article has been cited by other articles:

				G. D'Angelo, J. D. Mintz, J. E. Tidwell, A. M. Schreihofer, D. M. Pollock, and D. W. Stepp Exaggerated Cardiovascular Stress Responses and Impaired {beta}-Adrenergic-Mediated Pressor Recovery in Obese Zucker Rats Hypertension, December 1, 2006; 48(6): 1109 - 1115. [Abstract] [Full Text] [PDF]

				J. S. Naik, L. Xiang, and R. L. Hester Enhanced role for RhoA-associated kinase in adrenergic-mediated vasoconstriction in gracilis arteries from obese Zucker rats Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2006; 290(1): R154 - R161. [Abstract] [Full Text] [PDF]

				S. Malhotra, J. Poole, H. Davis, Y. Dong, J. Pollock, H. Snieder, and F. Treiber Effects of NOS3 Glu298Asp Polymorphism on Hemodynamic Reactivity to Stress: Influences of Ethnicity and Obesity Hypertension, December 1, 2004; 44(6): 866 - 871. [Abstract] [Full Text] [PDF]

				P. Battilana, G. Seematter, Ph. Schneiter, E. Jéquier, and L. Tappy Effects of Free Fatty Acids on Insulin Sensitivity and Hemodynamics during Mental Stress J. Clin. Endocrinol. Metab., January 1, 2001; 86(1): 124 - 128. [Abstract] [Full Text]

				G. Seematter, E. Guenat, P. Schneiter, C. Cayeux, E. Jequier, and L. Tappy Effects of mental stress on insulin-mediated glucose metabolism and energy expenditure in lean and obese women Am J Physiol Endocrinol Metab, October 1, 2000; 279(4): E799 - E805. [Abstract] [Full Text] [PDF]

				W. A. Bardwell, M. G. Ziegler, and J. E. Dimsdale Influence of Cholesterol and Fasting Insulin Levels on Blood Pressure Reactivity Psychosom Med, July 1, 2000; 62(4): 569 - 575. [Abstract] [Full Text] [PDF]

				K. J. Mather, S. Verma, B. Corenblum, and T. J. Anderson Normal Endothelial Function Despite Insulin Resistance in Healthy Women with the Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., May 1, 2000; 85(5): 1851 - 1856. [Abstract] [Full Text]

				B. H. Sung, J. L. Izzo Jr, P. Dandona, and M. F. Wilson Vasodilatory Effects of Troglitazone Improve Blood Pressure at Rest and During Mental Stress in Type 2 Diabetes Mellitus Hypertension, July 1, 1999; 34(1): 83 - 88. [Abstract] [Full Text] [PDF]