Cited by 2,344Diabetes, Cardiovascular Risks, and LipoproteinsBlood Pressure and Hypertension StudiesCardiovascular Function and Risk Factors

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Insulin Resistance in Essential Hypertension

Ferrannini, Eleuterio, Buzzigoli, Giuseppe, Bonadonna, Riccardo, Giorico, Maria Antonietta, Oleggini, Marco, Graziadei, Linda, Pedrinelli, Roberto, Brandi, Luigi, Bevilacqua, Stefano·1987·New England Journal of Medicine

DOI 10.1056/nejm198708063170605

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Abstract

High blood pressure is prevalent in obesity and in diabetes, both conditions with insulin resistance. To test whether hypertension is associated with insulin resistance independently of obesity and glucose intolerance, we measured insulin sensitivity (using the euglycemic insulin-clamp technique), glucose turnover (using [3H]glucose isotope dilution), and whole-body glucose oxidation (using indirect calorimetry) in 13 young subjects (38 +/- 2 years [+/- SEM]) with untreated essential hypertension (165 +/- 6/112 +/- 3 mm Hg), normal body weight, and normal glucose tolerance. In the postabsorptive state, all measures of glucose metabolism were normal. During steady-state euglycemic hyperinsulinemia (about 60 microU per milliliter), hepatic glucose production and lipolysis were effectively suppressed, and glucose oxidation and potassium disposal were normally stimulated. However, total insulin-induced glucose uptake was markedly impaired (3.80 +/- 0.32 vs. 6.31 +/- 0.42 mg per minute per kilogram of body weight in 11 age- and weight-matched controls, P less than 0.001). Thus, reduced nonoxidative glucose disposal (glycogen synthesis and glycolysis) accounted for virtually all the defect in overall glucose uptake (1.19 +/- 0.24 vs. 3.34 +/- 0.44 mg per minute per kilogram, P less than 0.001). Total glucose uptake was inversely related to systolic or mean blood pressure (r = 0.76 for both, P less than 0.001). These results provide preliminary evidence that essential hypertension is an insulin-resistant state. We conclude that this insulin resistance involves glucose but not lipid or potassium metabolism, is located in peripheral tissues but not the liver, is limited to nonoxidative pathways of intracellular glucose disposal, and is directly correlated with the severity of hypertension.

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Authors: Ferrannini, E., Buzzigoli, G., Bonadonna, R., Giorico, M. A., Oleggini, M., Graziadei, L., Pedrinelli, R., Brandi, L., & Bevilacqua, S.
ORCID: Bonadonna, Riccardo
Pedrinelli, Roberto
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 1987-08-06
Volume: 317
Issue: 6
Pages: 350-357
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejm198708063170605
OpenAlex: W2319850088
Semantic Scholar: 8f94bc06901b356e0488337d786981d8352e8bf1
Cited by: 2,344
References: 37
Citations by year: 2026: 7 · 2025: 16 · 2024: 17 · 2023: 22 · 2022: 21 · 2021: 25 · 2020: 12 · 2019: 23 · 2018: 21 · 2017: 40 · 2016: 28 · 2015: 31 · 2014: 39 · 2013: 47 · 2012: 45
FWCI: 45.05
Type: journal article
Language: en
Open access: closed
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords: insulin resistance, essential hypertension, insulin sensitivity, glucose uptake, nonoxidative glucose disposal, hepatic glucose production, lipolysis, glucose turnover, glucose oxidation, blood pressure, obesity, impaired glucose tolerance
MeSH terms: Adult, Blood Glucose, Female, Humans, Hypertension, Insulin, Insulin Resistance, Male

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Insulin Resistance in Essential Hypertension

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