Tissue insulin resistance and endothelial function of large vessels in patients with arterial hypertension

Aim. To examine insulin resistance and hyperinsulinemia in obese patients with moderate arterial hypertension (AH) without diabetes mellitus, glucose intolerance, and ischemic heart disease; to evaluate the endothelial vasomotor function of large vessels. Material and methods. 41 males (mean age 49.3 +/- 5.4 years) with All were examined by anthropometry, measurements of the levels of glucose, immunoreactive insulin, C-peptide, and biochemical blood tests. Endothelial vasomotor function was assessed ultrasonically. Results. Insulin resistance preceding abnormal glucose tolerance was found in 52.4% of the patients with AH and obesity. In these patients lipid metabolic disturbances were more pronounced than in those without hyperinsulinemia. There was endothelial vasomotor dysfunction with preserved capacity of arteriolar and capillary walls for vasodilatation irrespective of the presence or absence of insulin resistance. Conclusion. Insulin resistance and endothelial dysfunction are most common in hypertensive. patients with obesity.