CLINICAL AND HEMODYNAMIC CHARACTERISTICS OF PRIMARY ARTERIAL-HYPERTENSION ASSOCIATED WITH INSULIN-RESISTANCE - RELATIONSHIP BETWEEN LEFT-VENTRICULAR MYOCARDIAL MASS AND HYPERSECRETION OF INSULIN

Seventy one patients with mild and moderate hypertension were studied. None of them had coronary heart disease, peripheral or carotid athero sclerosis, diabetes or other endocrinopathies known to be accompanied by insulin resistance and hyperinsulinemia. Insulin resistance was dia gnosed in 59 of these patients because of C-peptidemia and/or hyperins ulinemia in fasting state and/or after oral glucose loading. Results o f 24-hour blood pressure monitoring in patients with insulin resistanc e were similar to those in other patients with hypertension. The state of hemodynamics in all patients was characterized by normal cardiac o utput, normal left ventricular and diastolic volume, and elevated peri pheral vascular resistance. However left ventricular myocardial mass ( assessed by R. Devereux technique) was significantly higher in patient s with insulin resistance. Correlation and multiple regression analysi s revealed existence of significant relationship between myocardial ma ss and blood pressure, plasma levels of C-peptide and insulin and plas ma renin activity. A conclusion is made that these humoral factors def initely contribute to the genesis of myocardial damage.