INCREASED FIBRINOGEN LEVELS IN THE OFFSPRING OF HYPERTENSIVE MEN - RELATION WITH HYPERINSULINEMIA AND THE METABOLIC SYNDROME

Epidemiological studies have revealed that elevated fibrinogen concent rations are associated with an increased risk of myocardial infarction , stroke, intermittent claudication, and cardiovascular mortality. The manner in which fibrinogen operates in atherogenesis has not yet been elucidated, but genetic control of fibrinogen levels is partially res ponsible. Fibrinogen frequently acts in concert with hyperlipidemia, d iabetes, hypertension, physical inactivity, and age, variables that ar e influenced by insulin action. Because the offspring of hypertensive men tend to be hyperinsulinemic and insulin resistant from a young age , we hypothesized that their increased fibrinogen levels might reflect decreased insulin action and thus play a role in the metabolic syndro me. We chose 48 adult offspring (mean age, 38.4 years) of 30 fathers w ho had been treated for hypertension, and the former were matched by a ge, body mass index, sex, and smoking habits with 37 control subjects. Elevations in fibrinogen concentration (3.63+/-0.93 versus 2.87+/-0.5 4 g/L, P<.001) paralleled increases in blood glucose and insulin level s, estimates of insulin resistance, and blood pressure. In the offspri ng, in contrast to the control group, correlations between fibrinogen and metabolic-syndrome variables (ie, insulin, glucose, and waist and hip circumferences) were found. In stepwise multiple regression analys es, age and smoking habits were entered as variables in both study gro ups, but postload insulin and high-density lipoprotein cholesterol wer e entered as variables in the offspring group only. We propose that fa milial predisposition influences the relationship between insulin conc entration and fibrinogen, an effect that may contribute to the clinica l importance of the metabolic syndrome.