Author/Editor		Žižek, B; Poredoš, P
Title		Insulin resistance adds to endothelial dysfunction in hypertensive patients and in normotensive offspring of subjects with essential hypertension
Type		članek
Source		J Intern Med
Vol. and No.		Letnik 249
Publication year		2001
Volume		str. 189-97
Language		eng
Abstract		Objectives. To evaluate whether endothelium-dependent (nitric oxide-mediated) dilation of the brachial artery (BA) is impaired in patients being treated for essential hypertension (EH), and whether this abnormality can be detected in normotensive offspring of subjects with EH (familial trait, FT); and to investigate the interrelationship between flowmediated vasodilation (FMD) and hyperinsulinaemia/insulin resistance. Design. Cross-sectional study. Setting. Angiology department at a teaching hospital. Subjects. The study encompassed 172 subjects, of whom 46 were treated hypertonics aged 40-55 (49) years, and 44 age-matched, normotensive volunteers as controls. We also investigated 41 normotonics with FT aged 20-30 (25) years and 41 age-and sex-matched controls without FT. Main outcome measures. Using high-resolution ultrasound, BA diameters at rest, during reactive hyperaemia (endothelium-dependent dilation) and after sublingual glyceryl trinitrate (GTN) application (endothelium-independent dilation) were measured. Results. In hypertonics FMD was significantly lower than in controls (2.4 (2.9) vs. 7.4 (2.5)%; P < 0.00005), as was GTN-induced dilation (12.1 (4.3) vs. 16.1 (4.6)%; P = 0.0007). In subjects with FT, FMD was also decreased compared with the control group (5.8 (4.1) vs. 10.0 (3.0)%; P < 0.00005). The response to GTN was comparable in both groups of young subjects. FMD was negatively related to insulin concentration in all subjects studied (P < 0.00005).
Descriptors		HYPERTENSION INSULIN RESISTANCE ENDOTHELIUM, VASCULAR ADULT MIDDLE AGE BRACHIAL ARTERY HYPERINSULINEMIA VASODILATION ENDOTHELIUM-DERIVED RELAXING FACTOR