Abstract:
:In normal subjects, insulin decreases the urinary excretion of sodium, potassium, and uric acid. We tested whether these renal effects of insulin are altered in insulin resistant hypertension. In 37 patients with essential hypertension, we measured the changes in urinary excretion of sodium, potassium, and uric acid in response to physiological euglycemic hyperinsulinemia (by using the insulin clamp technique at an insulin infusion rate of 6 pmol/min/kg). Glucose disposal rate averaged 26.6 +/- 1.5 mumol/min/kg, i.e., 20% lower than in normotensive controls (33.1 +/- 2.1 mumol/min/kg, P = .015) In the basal state, fasting plasma uric acid concentrations were higher in men than women (P < .001), were positively related to body mass index (r = 0.38, P = .02), waist/hip ratio (r = 0.35, P < .05), and serum triglyceride levels (r = 0.59, P = .0001), and negatively related to HDL cholesterol concentrations (r = -0.59, P = .0001) and glucose disposal rate (r = 0.42, P < .01). Uric acid clearance, on the other hand, was inversely related to body mass index (r = 0.41, P = .01), plasma uric acid (r = 0.65, P < .0001) and triglyceride concentrations (r = 0.39, P < .02), and directly related to HDL cholesterol levels (r = 0.52, P < .001). During insulin infusion, blood pressure, plasma uric acid and sodium concentration, and creatinine clearance did not change. In contrast, hyperinsulinemia caused a significant decrease in the urinary excretion of uric acid (2.67 +/- 0.12 to 1.86 +/- .14 mumol/min/1.73 m2, P = .0001), sodium (184 +/- 12 to 137 +/- 14 mumol/min/1.73 m2, P = .0001), and potassium (81 +/- 7 to 48 +/- 4 mumol/ min/1.73 m2, P = .0001). Both in absolute terms (clearance and fractional excretion rates) and percentagewise, these changes were similar to those found in normotensive subjects. Insulin-induced changes in urate excretion were coupled (r = 0.55, P < .0001) to the respective changes in sodium excretion. In hypertensive patients, higher uric acid levels and lower renal urate clearance rates cluster with insulin resistance and dyslipidemia. Despite insulin resistance of glucose metabolism, acute physiological hyperinsulinemia causes normal antinatriuresis, antikaliuresis, and antiuricosuria in these patients.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Muscelli E,Natali A,Bianchi S,Bigazzi R,Galvan AQ,Sironi AM,Frascerra S,Ciociaro D,Ferrannini Edoi
10.1016/0895-7061(96)00098-2subject
Has Abstractpub_date
1996-08-01 00:00:00pages
746-52issue
8eissn
0895-7061issn
1941-7225pii
0895706196000982journal_volume
9pub_type
临床试验,杂志文章abstract::Angiotensin receptors became relatively easy to study when radioactive derivatives of the peptide were synthesized for radioimmunoassays. Binding assays in vitro led to the discovery of receptors in many tissues different from those involved in the classic actions of angiotensin. The physiologic significance of recept...
journal_title:American journal of hypertension
pub_type: 历史文章,杂志文章
doi:10.1016/s0895-7061(99)00212-5
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abstract::The polymorphism of the angiotensin-converting enzyme gene is considered to be associated with increased risk for stroke, but there is a diversity in the results obtained. The genetic involvement of the renin-angiotensin system in stroke also remains unclear. To predict the genetic risk of lacunar infarction, we condu...
journal_title:American journal of hypertension
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/s0895-7061(03)00058-x
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Endothelial progenitor cells (EPCs) provide paracrine support to the vascular endothelium and may also replace damaged or senescent endothelial cells. Low numbers of endothelial progenitor colony-forming units (CFU-ECs) in culture are a predictive biomarker of vascular disease. We hypothesized that the numbe...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.101
更新日期:2009-09-01 00:00:00
abstract::Since we and others have found a decrease in intestinal Ca2+ absorption and renal Ca2+ reabsorption in the mature spontaneously hypertensive rat (SHR) at the tissue and cell level, we asked whether the transport defect was located at the luminal or the basolateral side of the epithelial cell. We studied intestinal and...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.7.593
更新日期:1993-07-01 00:00:00
abstract::High dietary Na+ raises mean arterial pressure (MAP) by more than 10% in salt-sensitive (SS) patients with essential hypertension. To test whether the rise in MAP in these patients is caused by a Na(+)-linked increase in [Ca2+]i in vascular smooth muscle cells, we measured [Ca2+]i in the lymphocytes of 14 patients wit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.8.536
更新日期:1992-08-01 00:00:00
abstract::Antihypertensive drugs are often initiated and adjusted over a period of weeks to months. It is not clear whether the time and inconvenience of this approach is necessary. We studied whether or not drug adjustment over several days in the context of a physician-nurse team could produce a durable blood pressure benefit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01273-5
更新日期:2001-04-01 00:00:00
abstract::A negative calcium balance has previously been described in human hypertension with low levels of plasma ionized calcium (Ca2+) and an increased urinary excretion of calcium. The cause of this disturbance in mineral metabolism is not known, nor is it known if this derangement could be abolished if blood pressure is re...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/7.4.302
更新日期:1994-04-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)01284-5
更新日期:2001-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.6
更新日期:2011-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01264-4
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Our aim was to assess whether home blood pressure (HBP) and ambulatory BP monitoring measurement (ABPM), in addition to office BP (OBP) predict changes of cardiovascular biomarkers during antihypertensive treatment. METHODS:Two hundred and fifty-two hypertensive patients (mean age, 68 years; men: 41%) under...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/ajh.2011.229
更新日期:2012-03-01 00:00:00
abstract::The renin-angiotensin-aldosterone system plays a major role in the pathogenesis of hypertension by enhancing the production or the activity of angiotensin II (ANG II). We evaluated the effects of hormone replacement therapy (HRT) on the renin-angiotensin-aldosterone system and on bradykinin in postmenopausal women (PM...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01253-x
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Hypertension presents high prevalence rates following kidney transplantation (Tx). The aims of the present study were to investigate the prevalence and possible risk factors for hypertension and blood pressure (BP) control over time after pediatric kidney Tx, as well as to assess possible effects of hyperten...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv192
更新日期:2016-07-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(99)00106-5
更新日期:1999-12-01 00:00:00
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journal_title:American journal of hypertension
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doi:10.1093/ajh/hpu055
更新日期:2014-11-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1093/ajh/hpv177
更新日期:2016-06-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.5.292
更新日期:1992-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2004-02-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/ajh/6.3.62s
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journal_title:American journal of hypertension
pub_type: 杂志文章
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更新日期:2001-06-01 00:00:00
abstract::The metabolic syndrome is a cluster of disturbances such as type 2 diabetes mellitus, hypertension, central obesity, dyslipidemia, and others for which insulin resistance and compensatory hyperinsulinemia have been proposed to be the underlying disorders. Several possible mechanisms linking insulin resistance and comp...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/j.amjhyper.2005.12.017
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Aging is a major risk factor for the development of arterial stiffness and vascular disease, and it is related to the upregulation of matrix metalloproteinase-2 (MMP-2) in the aorta of rats and nonhuman primates. This study aimed to determine whether MMP activity in the human vasculature changes with aging. ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.11.011
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:One effort to improve hypertension care in the United States is the development of the "Hypertension Specialist" program with appropriate training and certification of individual physicians. METHODS:We examined the impact of a hypertension clinic on blood pressure (BP) levels and control. RESULTS:By one ye...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(03)01030-6
更新日期:2003-10-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00321-x
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Left ventricular (LV) concentric geometry and hypertrophy, depressed wall mechanics, and abnormal diastolic properties have been described in the diabetic heart. However, the cardiac response to dynamic exercise in diabetic patients remains controversial. The present study assessed strain rate (SR) imaging d...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.12.009
更新日期:2007-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa207
更新日期:2020-12-05 00:00:00
abstract::The relations between left ventricular mass (LVM), peripheral resistance artery structure, and ambulatory BP were studied in 83 patients with previously untreated or poorly regulated essential hypertension and 20 healthy controls of similar age and sex. LVM was assessed by echocardiography. Signs of left ventricular h...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)00220-0
更新日期:1995-10-01 00:00:00
abstract::In a randomized double-blind, placebo-controlled, crossover study of isradipine (5 mg twice daily), effects on peripheral hemodynamic reflex responses were studied in nine patients (mean age 48 years) at baseline and after six weeks of active treatment. Assessments included vital signs, resting blood flow in the calf ...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ajh/4.2.194s
更新日期:1991-02-01 00:00:00
abstract::We investigated the effects of 17 beta-estradiol (beta E2), alpha-estradiol (alpha E2), and progesterone (P) on baseline and vasopressin (AVP)-induced [Ca2+]i in human platelets obtained from healthy male and female volunteers. Platelets were treated with beta E2, alpha E2, P, or ethanol vehicle for 30 min at 37 degre...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(94)00168-B
更新日期:1995-02-01 00:00:00