Effect of insulin on renal sodium and uric acid handling in essential hypertension.

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 Hypertens

authors

Muscelli E,Natali A,Bianchi S,Bigazzi R,Galvan AQ,Sironi AM,Frascerra S,Ciociaro D,Ferrannini E

doi

10.1016/0895-7061(96)00098-2

subject

Has Abstract

pub_date

1996-08-01 00:00:00

pages

746-52

issue

8

eissn

0895-7061

issn

1941-7225

pii

0895706196000982

journal_volume

9

pub_type

临床试验,杂志文章
  • Angiotensin receptors: history and mysteries.

    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

    authors: Goodfriend TL

    更新日期:2000-04-01 00:00:00

  • Gene polymorphism of the renin-angiotensin system associates with risk for lacunar infarction. The Ohasama study.

    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

    pub_type: 杂志文章

    doi:10.1016/s0895-7061(99)00184-3

    authors: Takami S,Imai Y,Katsuya T,Ohkubo T,Tsuji I,Nagai K,Satoh H,Hisamichi S,Higaki J,Ogihara T

    更新日期:2000-02-01 00:00:00

  • Use of an automated blood pressure recording device, the BpTRU, to reduce the "white coat effect" in routine practice.

    abstract:BACKGROUND:Patients often exhibit higher blood pressure (BP) readings in the doctor's office, a phenomenon known as the white coat effect. This study examines the presence of a physician in the examining room as a possible factor in provoking a white coat effect. METHODS:Blood pressure measurements taken by an automat...

    journal_title:American journal of hypertension

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0895-7061(03)00058-x

    authors: Myers MG,Valdivieso MA

    更新日期:2003-06-01 00:00:00

  • Maternal endothelial progenitor colony-forming units with macrophage characteristics are reduced in preeclampsia.

    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

    authors: Lin C,Rajakumar A,Plymire DA,Verma V,Markovic N,Hubel CA

    更新日期:2009-09-01 00:00:00

  • Increased brush-border membrane calcium transport in the intestine, but not the kidney tubule, of spontaneously hypertensive rats.

    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

    authors: Hennessen U,Chabanis S,Silva SL,Nabarra B,Drüeke T,Lacour B

    更新日期:1993-07-01 00:00:00

  • Effect of dietary sodium intake on intracellular calcium in lymphocytes of salt-sensitive hypertensive patients.

    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

    authors: Alexiewicz JM,Gaciong Z,Parise M,Karubian F,Massry SG,Campese VM

    更新日期:1992-08-01 00:00:00

  • Rapid adjustment of antihypertensive drugs produces a durable improvement in blood pressure.

    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

    authors: Canzanello VJ,Jensen PL,Hunder I

    更新日期:2001-04-01 00:00:00

  • Influences of different antihypertensive treatments on indices of systemic mineral metabolism.

    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

    authors: Lind L,Hänni A,Hvarfner A,Pollare T,Ljunghall S,Lithell H

    更新日期:1994-04-01 00:00:00

  • Reference values for clinic pulse pressure in a nonselected population.

    abstract::A wide pulse pressure (PP) may constitute an independent predictor of cardiovascular morbidity and mortality. We assessed the reference values of brachial clinic PP, according to age and gender in a nonselected population (61,724 subjects) who were undergoing a routine systematic health examination. According to mean ...

    journal_title:American journal of hypertension

    pub_type: 杂志文章

    doi:10.1016/s0895-7061(01)01284-5

    authors: Asmar R,Vol S,Brisac AM,Tichet J,Topouchian J

    更新日期:2001-05-01 00:00:00

  • Temporary treatment with AT1 receptor blocker, valsartan, from early stage of hypertension prevented vascular remodeling.

    abstract:BACKGROUND:The present study examined the inhibitory action of temporary treatment with an angiotensin type 1 (AT(1)) receptor blocker (ARB) on vascular remodeling using hypertensive mice with overexpression of the human renin (hRN) and angiotensinogen (hANG) genes. METHODS:hRN/hANG transgenic mice (hRN/hANG-Tg) were ...

    journal_title:American journal of hypertension

    pub_type: 杂志文章

    doi:10.1038/ajh.2011.6

    authors: Inaba S,Iwai M,Furuno M,Kanno H,Senba I,Okayama H,Mogi M,Higaki J,Horiuchi M

    更新日期:2011-05-01 00:00:00

  • Left ventricular function impairment in pregnancy-induced hypertension.

    abstract::The changes induced by transient hypertension on cardiac structure and function are unclear. Pregnancy-induced hypertension offers a natural and spontaneous model of this condition. To assess the potential of echocardiographic Doppler to unmask left ventricular function impairment, we studied 28 women aged 26.4 +/- 7....

    journal_title:American journal of hypertension

    pub_type: 杂志文章

    doi:10.1016/s0895-7061(00)01264-4

    authors: Vázquez Blanco M,Roisinblit J,Grosso O,Rodriguez G,Robert S,Berensztein CS,Vega HR,Lerman J

    更新日期:2001-03-01 00:00:00

  • Association of home and ambulatory blood pressure changes with changes in cardiovascular biomarkers during antihypertensive treatment.

    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

    authors: Yano Y,Hoshide S,Shimizu M,Eguchi K,Ishikawa J,Ishikawa S,Shimada K,Kario K

    更新日期:2012-03-01 00:00:00

  • Hormone replacement therapy increases plasma level of angiotensin II in postmenopausal hypertensive women.

    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

    authors: Umeda M,Ichikawa S,Kanda T,Sumino H,Kobayashi I

    更新日期:2001-03-01 00:00:00

  • Long-Term Changes in Blood Pressure After Pediatric Kidney Transplantation.

    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

    authors: Stabouli S,Printza N,Dotis J,Gkogka C,Kollios K,Kotsis V,Papachristou F

    更新日期:2016-07-01 00:00:00

  • Hypertension and sudden cardiac death.

    abstract::Left ventricular hypertrophy (LVH) has been identified as one of the strongest blood pressure-independent risk factors for sudden death, acute myocardial infarction, congestive heart failure, and other cardiovascular morbidity and mortality. Hypertensive patients with LVH have a significantly greater prevalence of pre...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,评审

    doi:10.1016/s0895-7061(99)00106-5

    authors: Messerli FH

    更新日期:1999-12-01 00:00:00

  • Obese children and adolescents have elevated nighttime blood pressure independent of insulin resistance and arterial stiffness.

    abstract:BACKGROUND:Insulin resistance has been related to elevated blood pressure (BP) in obese children and may adversely affect the vasculature by arterial stiffening. The objective was to investigate whether daytime and nighttime BP were elevated and related to insulin resistance and arterial stiffness in obese children and...

    journal_title:American journal of hypertension

    pub_type: 杂志文章

    doi:10.1093/ajh/hpu055

    authors: Hvidt KN,Olsen MH,Holm JC,Ibsen H

    更新日期:2014-11-01 00:00:00

  • Functional Status and Antihypertensive Therapy in Older Adults: A New Perspective on Old Data.

    abstract:BACKGROUND:Functional status may be useful for identifying older adults who benefit from lower blood pressure. We examined whether functional status modifies the effect of antihypertensive treatment among older adults. METHODS:Post hoc analyses of the Systolic Hypertension in the Elderly Program (SHEP), a randomized t...

    journal_title:American journal of hypertension

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/ajh/hpv177

    authors: Charlesworth CJ,Peralta CA,Odden MC

    更新日期:2016-06-01 00:00:00

  • Relation of left ventricular hypertrophy, afterload, and contractility to left ventricular performance in Goldblatt hypertension.

    abstract::To analyze the determinants of left ventricular (LV) performance (myocardial afterload, chamber size, mass, and contractility) in Goldblatt hypertension, 19 anesthetized one-kidney, one-clip (1K1C) and 28 two-kidney, one-clip (2K1C) male Wistar rats were studied 58 to 62 days after clipping, together with 19 sham-oper...

    journal_title:American journal of hypertension

    pub_type: 杂志文章

    doi:10.1093/ajh/5.5.292

    authors: de Simone G,Devereux RB,Volpe M,Camargo MJ,Wallerson DC,Laragh JH

    更新日期:1992-05-01 00:00:00

  • Omapatrilat and enalapril in patients with hypertension: the Omapatrilat Cardiovascular Treatment vs. Enalapril (OCTAVE) trial.

    abstract:BACKGROUND:Recent reports suggest that existing antihypertensive agents may not have sufficient efficacy to control blood pressure (BP) in many patients. Omapatrilat, an agent under development, has been shown to have significantly greater antihypertensive efficacy than existing agents, but may also carry increased ris...

    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:10.1016/j.amjhyper.2003.09.014

    authors: Kostis JB,Packer M,Black HR,Schmieder R,Henry D,Levy E

    更新日期:2004-02-01 00:00:00

  • Reexamining the quality of life of hypertensive patients. A new self-structured measure.

    abstract::This study included the introduction of a new, qualitative, self-structured measure of quality of life (QOL) after meta-analysis had shown that prestructured quantitative measures yielded insignificant results. This study compared the pre- and post-treatment evaluations of 268 men with mild hypertension, aged 40 to 65...

    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

    authors: Bar-On D,Amir M

    更新日期:1993-03-01 00:00:00

  • Renal macrostructure and cortical circulation in hypertension assessed by dynamic computed tomography.

    abstract::The aim of this study was to assess the macrostructure of the kidney and the grade of heterogeneity in renal cortical circulation in the early stages of essential hypertension. The subjects consisted of 84 patients (<50 years old) who underwent dynamic computed tomography (CT) because of various abdominal diseases and...

    journal_title:American journal of hypertension

    pub_type: 杂志文章

    doi:10.1016/s0895-7061(00)01281-4

    authors: Kojima S,Shida M,Tanaka K,Takano H,Yokoyama H,Kuramochi M

    更新日期:2001-06-01 00:00:00

  • Actions of peroxisome proliferator-activated receptors-gamma agonists explaining a possible blood pressure-lowering effect.

    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

    authors: Sarafidis PA,Lasaridis AN

    更新日期:2006-06-01 00:00:00

  • Aging is associated with increased matrix metalloproteinase-2 activity in the human aorta.

    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

    authors: McNulty M,Spiers P,McGovern E,Feely J

    更新日期:2005-04-01 00:00:00

  • Blood pressure control in the hypertension clinic.

    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

    authors: Bansal N,Tendler BE,White WB,Mansoor GA

    更新日期:2003-10-01 00:00:00

  • Ambulatory blood pressure in air traffic controllers.

    abstract::Conflicting reports exist as to whether air traffic controllers (ATC) have an increase in blood pressure (BP) and prevalence of hypertension because of the stressful nature of their job. We have addressed the issue in male ATC working at the Linate airport of Milan. A total of 80 ATC participated, and the 24 h blood p...

    journal_title:American journal of hypertension

    pub_type: 杂志文章

    doi:10.1016/s0895-7061(97)00321-x

    authors: Sega R,Cesana G,Costa G,Ferrario M,Bombelli M,Mancia G

    更新日期:1998-02-01 00:00:00

  • Impaired inotropic response in type 2 diabetes mellitus: a strain rate imaging study.

    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

    authors: Galderisi M,de Simone G,Innelli P,Turco A,Turco S,Capaldo B,Riccardi G,de Divitiis O

    更新日期:2007-05-01 00:00:00

  • Dapagliflozin does not affect short-term blood pressure variability in patients with type-2 diabetes mellitus.

    abstract:BACKGROUND:Increased blood-pressure-variability (BPV) is associated with increased cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus (T2DM). Sodium-glucose-co-transporter-2 (SGLT-2) inhibitors decrease the incidence of cardiovascular events, renal events, and death in this population. Thi...

    journal_title:American journal of hypertension

    pub_type: 杂志文章

    doi:10.1093/ajh/hpaa207

    authors: Papadopoulou E,Theodorakopoulou MP,Loutradis C,Tzanis G,Tzatzagou G,Kotsa K,Zografou I,Tsapas A,Karagiannis A,Sarafidis P

    更新日期:2020-12-05 00:00:00

  • The relation between peripheral vascular structure, left ventricular hypertrophy, and ambulatory blood pressure in essential hypertension.

    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

    authors: Sihm I,Schroeder AP,Aalkjaer C,Holm M,Mørn B,Mulvany M,Thygesen K,Lederballe O

    更新日期:1995-10-01 00:00:00

  • Effects of isradipine on peripheral hemodynamic reflex responses in mild-to-moderate essential hypertension.

    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

    authors: Duprez D,De Backer T,De Pue N,Hermans L,De Buyzere M,Clement DL

    更新日期:1991-02-01 00:00:00

  • Effects of estradiol and progesterone on platelet calcium responses.

    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

    authors: Raman BB,Standley PR,Rajkumar V,Ram JL,Sowers JR

    更新日期:1995-02-01 00:00:00