Hyperinsulinemia. A link between hypertension obesity and glucose intolerance.

Modan, M; Halkin, H; Almog, S; Lusky, A; Eshkol, A; Shefi, M; Shitrit, A; Fuchs, Z

doi:10.1172/jci111776

Cited by 1,465Diabetes, Cardiovascular Risks, and LipoproteinsBlood Pressure and Hypertension StudiesAdipokines, Inflammation, and Metabolic Diseases

Hyperinsulinemia. A link between hypertension obesity and glucose intolerance.

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Modan, M, Halkin, H, Almog, S, Lusky, A, Eshkol, A, Shefi, M, Shitrit, A, Fuchs, Z·1985·Journal of Clinical Investigation

DOI 10.1172/jci111776PMC PMC423608

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Abstract

Hypertension and glucose intolerance, determined in a random population sample (n = 2,475), showed a highly significant (P less than 0.001) association from the mildest levels of both conditions, independent of the confounding effects of age, sex, obesity, and antihypertensive medications. Summary rate ratios for hypertension were 1.48 (1.18-1.87) in abnormal tolerance and 2.26 (1.69-2.84) in diabetes compared with normal tolerance. Altogether, 83.4% of the hypertensives were either glucose-intolerant or obese--both established insulin-resistant conditions. Fasting and post-load insulin levels in a representative subgroup (n = 1,241) were significantly elevated in hypertension independent of obesity, glucose intolerance, age, and antihypertensive medications. The mean increment in summed 1- and 2-h insulin levels (milliunits per liter) compared with nonobese normotensives with normal tolerance was 12 for hypertension alone, 47 for obesity alone, 52 for abnormal tolerance alone, and 124 when all three conditions were present. The prevalence of concentrations (milliequivalents per liter) of erythrocyte Na+ greater than or equal to 7.0, K+ less than 92.5, and plasma K+ greater than or equal to 4.5 in a subsample of 59 individuals with all combinations of abnormal tolerance obesity and hypertension was compared with those in 30 individuals free of these conditions. Altogether, 88.1% of the former vs. 40.0% of the latter group presented at least one of these three markers of internal cation imbalance (P less than 0.001). We conclude that insulin resistance and/or hyperinsulinemia (a) are present in the majority of hypertensives, (b) constitute a common pathophysiologic feature of obesity, glucose intolerance, and hypertension, possibly explaining their ubiquitous association, and (c) may be linked to the increased peripheral vascular resistance of hypertension, which is putatively related to elevated intracellular sodium concentration.

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Insulin levels and/or insulin resistance are associated with hypertension in both obese and nonobese people.
“many subsequent clinical and population-based studies showed an association of insulin levels and ⁄ or insulin resistance with hypertension in both obese and nonobese people.12,13”
From Obesity‐Related Hypertension: Pathogenesis, Cardiovascular Risk, and Treatment: A Position Paper of The Obesity Society and the American Society of Hypertension (2013) · cites this paper as [13]

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Authors: Modan, M., Halkin, H., Almog, S., Lusky, A., Eshkol, A., Shefi, M., Shitrit, A., & Fuchs, Z.
Affiliations: Tel Aviv University (IL)
ORCID: Shitrit, A
Venue: Journal of Clinical Investigation
Publisher: American Society for Clinical Investigation
Published: 1985-03-01
Volume: 75
Issue: 3
Pages: 809-817
ISSN: 0021-9738 (ISSN-L)
DOI: 10.1172/jci111776
PMC: PMC423608
OpenAlex: W2151522859
Cited by: 1,465
References: 80
Citations by year: 2026: 4 · 2025: 4 · 2024: 7 · 2023: 9 · 2022: 9 · 2021: 22 · 2020: 16 · 2019: 16 · 2018: 13 · 2017: 21 · 2016: 18 · 2015: 14 · 2014: 23 · 2013: 17 · 2012: 25
FWCI: 27.45
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Clinical Investigation (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
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 › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords: hyperinsulinemia, hypertension, obesity, impaired glucose tolerance, insulin resistance, diabetes mellitus, electrolyte imbalance, plasma potassium, erythrocyte sodium, systemic vascular resistance
MeSH terms: Adult, Age Factors, Aged, Body Surface Area, Diabetes Mellitus, Diabetes Mellitus, Type 2, Erythrocytes, Glucose Tolerance Test, Humans, Hypertension, Insulin, Middle Aged, Obesity, Potassium, Sodium

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Hyperinsulinemia. A link between hypertension obesity and glucose intolerance.

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