HYPERINSULINEMIA IN RELATION TO HYPERTENSION AND OTHER CORONARY RISK-FACTORS IN JAPANESE MEN

In addition to obesity, abnormalities in glucose and lipid metabolism are common in hypertensives, indicating a possible link between hypert ension and hyperinsulinemia. Since the frequency of obesity in Japanes e is lower than that in Caucasians, the present study was designed to clarify the frequencies of hyperinsulinemia, glucose and lipid abnorma lities, and obesity. We surveyed consecutively 470 men without a histo ry of gastrectomy who visited a health clinic after excluding previous ly known hypertensives receiving hypotensive agents (4.2%) and diabeti cs (6.1%). Hypertensives with a blood pressure exceeding 150 and/or 90 mmHg (n = 62) had a significantly higher frequency of diabetes mellit us (6.5%) associated with hypercholesterolemia (24.2%) and mild obesit y with a body mass index (BMI) of more than 25 (24.2%) than those of n ormotensives. When reanalyzed according to the presence or absence of hyperinsulinemia after 75 g oral glucose loading, hyperinsulinemic men demonstrated a higher blood pressure. The incidences of impaired gluc ose tolerance (67.1%), hypertriglyceridemia (64.4%), low HDL-cholester ol (53.4%), hypercholesterolemia (21.9%) and mild obesity (37.0%) were also significantly higher than those of normoinsulinemic subjects. Su bjects with either hypertension and/or hyperinsulinemia had a signific antly higher incidence of coexistence of these risk factors. Multiple regression analysis revealed that not only BMI, but also the plasma gl ucose and insulin response during the 75 g glucose loading test indepe ndently correlated with mean blood pressure. These results suggest tha t hypertensive and/or hyperinsulinemic subjects may be associated with excess cardiovascular risk and should be managed more carefully.