METABOLIC DERANGEMENTS IN NONMODULATING HYPERTENSION

A positive association exists between insulin resistance, dyslipidemia , and hypertension, specifically salt-sensitive hypertension. A subgro up of salt-sensitive normal and high renin hypertensives called nonmod ulators (NM) manifest an inability to modulate the adrenal and renal b lood flow responses to a change in dietary sodium. Therefore, we teste d the hypothesis that the NM subgroup would be insulin resistant and d yslipidemic when compared with normal and high renin hypertensives, in whom modulation is intact (M). Forty-six nondiabetic hypertensive ind ividuals were evaluated and their modulation status defined by either renal or adrenal criteria. Fasting blood was drawn for measurement of several metabolic factors. Since the NM group had a greater body mass index (BMI) it was subdivided into a ''lean'' subgroup that matched th e BMI of the M group. The fasting insulin levels in both the total NM and lean NM groups was significantly higher than in the M group (P = . 013 and .04, respectively). There were no differences in age, blood pr essure, or plasma/serum levels of glucose, triglycerides, total choles terol, or potassium. NM had elevated fasting insulin levels compared t o M, compatible with an insulin resistant state, but this insulin resi stance was not accompanied by higher lipid levels, suggesting that dys lipidemia and insulin resistance are dissociable in the hypertensive p opulation.