December 1, 1997Clinical Science
‘Physiological’ Hyperinsulinaemia Increases Distal Artery Systolic Blood Pressure without Changing Proximal Blood Pressure
Why the study?
Does physiological hyperinsulinaemia increase distal and proximal blood pressure in humans?
Population
Humans (sample size and specific demographics not stated in abstract)
Comparison
Low- and high-dose insulin infusions during a… vs Control infusion
Follow-up
Acute (during infusion)
Authors
Discussion
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Implication
May link hyperinsulinemia to hypertension via pulse wave reflection; leaves open causal role in essential hypertension pending confirmatory studies.
Key Points
- To evaluate the acute haemodynamic effects of physiological hyperinsulinaemia on distal versus proximal blood pressure.
- Measured blood pressure concurrently in the finger (Finapres) and arm (Dinamap monitor) during a two-stage euglycaemic clamp.
- Administered low-dose (28.9 +/- 2.1 mu-units/ml) and high-dose (101.7 +/- 6.8 mu-units/ml) insulin infusions, comparing responses against a control infusion.
- From a baseline of 130 +/- 3 mmHg, finger systolic blood pressure increased by 9.9 +/- 1.9 mmHg with low-dose insulin (vs 7.5 +/- 2.7 mmHg in control, P < 0.05) and by 21.9 +/- 2.3 mmHg with high-dose insulin (vs 14.6 +/- 3.1 mmHg in control, P < 0.01).
- Insulin produced no significant additional changes compared with control in arm systolic blood pressure or mean blood pressure.
Structured PICO
Does physiological hyperinsulinaemia increase distal and proximal blood pressure in humans?
P
Population
Humans (sample size and specific demographics not stated in abstract)
I
Intervention
Low- and high-dose insulin infusions during a two-stage euglycaemic clamp (achieving plasma insulin concentrations of 28.9 +/- 2.1 and 101.7 +/- 6.8 mu-units/ml, respectively)
C
Comparator
Control infusion
O
Outcome
Acute effects on proximal (arm) and distal (finger) blood pressuresurrogate
Physiological hyperinsulinaemia acutely increases distal systolic blood pressure without affecting proximal blood pressure, suggesting augmented pulse wave reflection that may link insulin resistance to essential hypertension.
Cite This Study
O’Callaghan et al. (1997) studied this question.