INSULIN-RESISTANCE IN ESSENTIAL-HYPERTENSION IS RELATED TO PLASMA-RENIN ACTIVITY

A high plasma renin activity (PRA) has previously been related to seve ral cardiovascular risk factors as well as to later cardiovascular eve nts. As insulin resistance has been suggested as the unifying factor i n the insulin resistance metabolic syndrome, insulin resistance was ev aluated by the euglycaemic hyperinsulinaemic clamp technique in 50 unt reated hypertensive subjects in whom PRA and serum aldosterone were me asured together with lipids and an intravenous glucose tolerance test (IVGTT). PRA was inversely related to insulin-mediated glucose disposa l during the clamp (r = -0.31, P < 0.05), as well as to fasting insuli n (r = 0.32, P < 0.05) and to insulin at 60 min at the IVGTT (r = 0.30 , P < 0.05), but not to other risk factors. Serum aldosterone was not related to any of the metabolic risk factors. In conclusion, the prese nt investigation showed that insulin resistance is associated with ele vated levels of PRA in patients with untreated essential hypertension. It thus seems as if a high activity in the renin system should be inc luded in the disturbances included in the insulin resistance metabolic syndrome, a syndrome with a major impact on future cardiovascular eve nts.