Key result
Insulin infusion during a euglycemic clamp significantly increased systolic blood pressure (119.8 vs 114.0 mmHg) and catecholamine levels compared to placebo in healthy subjects (p<0.001).
Why the study?
Does hyperinsulinemia induced by a euglycemic clamp increase blood pressure and catecholamine levels in healthy subjects?
RCT (n=50)
Double-blind
Does hyperinsulinemia induced by a euglycemic clamp increase blood pressure and catecholamine levels in healthy subjects?
Absolute Event Rate: 119.8% vs 114%
p-value: p=<0.001
Hyperinsulinemia within the normal physiological range acutely increases systolic blood pressure and sympathetic nervous system activation in healthy subjects.
Establishes acute pressor effect of physiological hyperinsulinemia; confirms sympathetic activation and extends mechanistic insights to hyperinsulinemic states.
Hyperinsulinemia has been shown to induce vasodilation and activation of the sympathetic nervous system. Whether these effects result in changes in blood pressure (BP) is discussed controversially. We measured BP and catecholamine levels in 50 healthy subjects during a 40-min baseline phase and during a 100-min euglycemic clamp phase. In a double-blind, between-subject comparison, 30 subjects were infused with 1.5mU insulin/kg x min, 20subjects were infused with saline solution. Insulin levels increased during insulin infusion from (mean+/-SE) 23.7 0.6 pmol/l to 406.2+/-3.0 pmol/l, but remained unchanged during placebo infusion. Blood glucose levels were identical during both conditions. Systolic BP increased from 116.6+/-1.5 mmHg to 119.8+/-1.8 mmHg during insulin infusion and decreased from 116.6+/-2.3 mmHg to 114.0+/-2.4 mmHg during placebo infusion (p<0.001, for the difference between the effects of insulin vs. placebo). Heart rate was higher during insulin infusion as compared to placebo infusion (63.8+/-1.9 vs. 60.9+/-2.4 beats/min, p<0.05). Norepinephrine levels increased from 1.25+/-0.09 to 1.58+/-0.12 nmol/l during insulin infusion and remained unchanged during placebo infusion (1.24+/-0.09 vs. 1.29+/-0.11 pmol/l; p<0.001). Epinephrine levels were also higher during insulin as compared to placebo infusion (249.8+/-17.4 vs. 212.8+/-21.1 pmol/l, p<0.001). The changes did not depend on whether the subject experienced his first or second clamp. Data demonstrate reproducable increasing effects of hyperinsulinemia within the normal physiological range on catecholamine release and systolic BP in healthy humans.
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Kern et al. (2000) conducted an RCT in Healthy (n=50). Insulin vs. Saline solution was evaluated on Systolic blood pressure (p=<0.001). Insulin infusion during a euglycemic clamp significantly increased systolic blood pressure (119.8 vs 114.0 mmHg) and catecholamine levels compared to placebo in healthy subjects (p<0.001).