INSULIN-RESISTANCE AND ESSENTIAL ARTERIAL-HYPERTENSION IN VIETNAMESE SUBJECTS

Several epidemiological and experimental studies suggest that essentia l arterial hypertension is associated with hyperinsulinism and insulin resistance in obese subjects and also in subjects with normal body we ight. Undernutrition remains frequent in adult Vietnamese people and m ean body mass index is around 18.5 kg/m(2) in Vietnam. The aim of this study was to look for insulin resistance in hypertensive Vietnamese s ubjects, despite a markedly lower BMI in Vietnam than in occidental co untries. One hundred and eight hypertensive patients (51 men and 57 wo men) over 40 years (mean = 65.4 years) were compared with 36 healthy s ubjects (23 men and 13 women) over 40 years (mean = 63.8 years). Hyper tensive patients had significantly higher BMI (20.5 +/- 0.3 (SEM) kg/m (2) vs 18.4 +/- 0.4 kg/m(2); p < 0.01), thicker triceps skinfold (1.26 +/- 0.07 cm vs 0.71 +/- 0.07 cm; p < 0.001) and not significantly dif ferent waist/hip ratio (0.88 +/- 0.01 vs 0.85 +/- 0.01). Blood glucose at fasting and 2 hours after 75 g glucose taken orally were similar i n hypertensive and normotensive subjects. Plasma insulin at fasting an d 2 hours after glucose were significantly higher in hypertensive pati ents (44.4 +/- 5.1 pmol/L vs 21.6 +/- 3.2 pmol/L; p < 0.05 and 271.1 /- 21.6 pmol/L vs 139.1 +/- 15.2 pmol/L; p < 0.001). Thus, despite und ernutrition, hypertensive Vietnamese patients have a moderate but sign ificant increase in BMI and fat mass without predominant abdominal loc alization, and a state of insulinresistance, compared with normotensiv e healthy subjects.