THE RELATIONSHIP OF HYPERINSULINEMIC STATE TO LEFT-VENTRICULAR HYPERTROPHY, MICROALBUMINURIA, AND PHYSICAL-FITNESS IN BORDERLINE AND MILD HYPERTENSION

The relationship of the hyperinsulinemic state to left ventricular hyp ertrophy, left ventricular geometric patterns, microalbuminuria, and p hysical fitness were studied in 52 middle-aged unmedicated men with bo rderline and mild hypertension. Left ventricular mass index and relati ve wall thickness were assessed by echocardiography, Physical fitness was determined by symptom-limited maximal treadmill stress testings. T he urinary concentration of microalbumin and C-peptide was measured in 24-h urine samples by radioimmunoassey. The 24-h urinary C-peptide ex cretion rate was correlated with left ventricular mass index (r = 0.46 ), relative wall thickness (r = 0.41), treadmill time (I = -0.35), nor malized treadmill time (r = -0.52), systolic blood pressure at peak ex ercise (r = 0.29), and 24-h urinary microalbumin excretion (r = 0.48). Stepwise multiple regression analysis identified the left ventricular mass index, the 24-h urinary albumin excretion, and the normalized tr eadmill time as variables in the equation for the 24-h urinary C-pepti de excretion. Thus, the hyperinsulinemic state is related to left vent ricular hypertrophy, microalbuminuria, and impaired physical fitness i n patients with borderline and mild hypertension. (C) 1997 American Jo urnal of Hypertension, Inc.