PLASMA-INSULIN AND ANKLE ON BRACHIAL SYSTOLIC BLOOD-PRESSURE RATIO INOVERWEIGHT MEN WITH HYPERTENSION

Background Hypertension is often associated with multiple metabolic ab normalities included in the insulin resistance syndrome. In hypertensi ve individuals, the ratio between ankle and brachial systolic blood pr essure (ABI) is considered to be an independent cardiovascular risk fa ctor. Insulin resistance has not been studied in relation to ABI ratio in men with essential hypertension and who are moderately overweight. Objective To identify whether a decrease in the ABI ratio is associat ed with the degree of abdominal obesity and, hence, with the biochemic al characteristics of resistance to insulin. Methods In 166 overweight men with mild-to-moderate essential hypertension, insulinaemia was me asured using radioimmunoassay. The ABI ratio was measured by using a p ressure cuff of appropriate diameter, a standard mercury sphygmomanome ter and a Doppler probe. Patients with diabetes or arteriosclerosis ob literans of the lower limbs, or both, were excluded from the study. Re sults The ABI ratio was significantly associated with the degree of ab dominal obesity, but also with plasma triglycerides and cholesterol, l ow high-density lipoprotein cholesterol, plasma glucose and insulin. I n a multiple regression analysis, the ABI ratio was significantly and negatively associated with only two variables: age and plasma insulin. This result was independent of age and drug treatment of hypertension . Conclusion Because alterations in the ABI ratio may be considered ma rkers of the changes in the structure and function of the arteries of lower limbs, the study provides evidence that plasma insulin, independ ently of atherosclerotic occlusive lesions, can significantly influenc e the status of conduit arteries of the lower limbs. (C) 1998 Rapid Sc ience Ltd.