THE INFLUENCE OF HYPERINSULINEMIA IN THE LIPID PROFILE OF HYPERTENSIVE PATIENTS

BACKGROUND: Hypertension and dyslipemia are associated with a greater frequency than that randomly expected. The increase in insulinic resis tence hyperinsulinemia is one of the factors implicated in the pathoge nesis of this association. In the present study the lipid profile of h ypertensive patients is analyzed according to the degree of insulinemi a. METHODS: The lipid profile (total cholesterol, fraction linked to l ow density lipoproteins cLDL high density cHDL triglycerides and plasm a apolipoproteins A1 and B were determined in 87 patients with essenti al high blood pressure. Moreover an oral overdose of 75 g of glucose w as administered with determinations of glycemia, insulinemia and C pep tide at the time of glucose administration, 60 and 120 minutes. RESULT S: Upon separation of the hypertense patients into two groups accordin g to the insulinemia achieved following an oral overload of glucose, t hose hypertensives with a greater degree of insulinemia showed a signi ficant increase in triglycerides (p < 0.05) and also a significant dec rease in cHDL (p < 0.001). The hypertensive patients with lower insuli nemia showed a significant increase in total cholesterol (p < 0.05) an d fraction linked to LDL although the latter was not significant. CONC LUSIONS: Two different lipid profiles may be observed in hypertensive patients: one linked to hyperinsulinemia and characterized by an incre ase in triglycerides and a decrease in cHDL and another with no relati on with hyperinsulinemia which is manifested by an increase in total c holesterol and cholesterol transported by the LDL.