Hypertension, Vol 7, 702-706, Copyright © 1985 by American Heart Association
CP Lucas, JA Estigarribia, LL Darga and GM Reaven
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/height2), 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 less than 0.001) even when age,
weight, and serum glucose level were controlled (r = 0.41, p = 0.025 and r
= 0.62, p less than 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.
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