Suppression of Post-Glucose Hyperinsulinaemia Does Not Affect Blood Pressure in Either Normotensive or Hypertensive Subjects

1998 ◽  
Vol 94 (6) ◽  
pp. 609-614
Author(s):  
Mark W. Savage ◽  
Vidya Mohamed-Ali ◽  
Gareth Williams
Keyword(s):  
Blood Pressure ◽  
Insulin Response ◽  
Control Group ◽  
Oral Glucose ◽  
Short Term ◽  
Hypertensive Patients ◽  
Hypertensive Group ◽  
Glucose Ingestion ◽  
Regulation Of Blood Pressure ◽  
Noradrenaline Levels

1. Hyperinsulinaemia and insulin resistance are thought to be intimately involved in the development of hypertension, but controversy remains as to whether hyperinsulinaemia is a consequence or a cause of hypertension per se, and whether it plays a role in the short-term regulation of blood pressure. 2. We studied six hypertensive patients [blood pressure 161(9)/101(2) mmHg] and seven normotensive control subjects [blood pressure 122(6)/76(4) mmHg], (P < 0.005) using two oral glucose tolerance tests of 3 h duration. In one of these tests the endogenous insulin response was inhibited with subcutaneous octreotide. 3. After placebo, hypertensive patients had slightly but significantly higher blood glucose levels than controls (P < 0.0001), but comparable insulin concentrations (P > 0.5). Plasma noradrenaline levels were consistently lower in the hypertensive group (P < 0.001). Blood pressure did not change in either group during the 3 h after glucose ingestion. 4. Octreotide completely abolished the immediate insulin response to glucose in all subjects (both P < 0.0001) and caused a delayed and significantly increased glycaemic response in born groups (P < 0.0001). There were no significant differences in plasma glucose responses between groups; however, after octreotide, the hypertensive subjects had a greater insulin suppression than the controls (P < 0.02). Octreotide suppressed noradrenaline levels in the normotensive group (P < 0.001); they were also suppressed in the hypertensive group, but just failed to reach significance (P = 0.056). Throughout the study the hypertensive group's noradrenaline levels remained generally lower than those in the control group (P < 0.0001). 5. In this study there were no differences between hypertensive and normotensive subjects in fasting or post-glucose insulin levels, nor any significant change in blood pressure in either group when post-glucose hyperinsulinaemia was suppressed. This argues against insulin playing a direct role in the short-term regulation of blood pressure.

P0152EFFECT OF LOSARTAN ON AMBULATORY SHORT-TERM BLOOD PRESSURE VARIABILITY AND CARDIOVASCULAR REMODELING IN HYPERTENSIVE PATIENTS ON HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Koichi Azuma
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Plasma Levels ◽  
Inhibitory Effect ◽  
Left Ventricular ◽  
Control Treatment ◽  
Control Group ◽  
Short Term ◽  
Hypertensive Patients ◽  
Cardiovascular Remodeling

Abstract Background and Aims Previous studies have shown increases in ambulatory short-term blood pressure (BP) variability to be related to cardiovascular disease. In this study, we examined whether an angiotensin II type 1 receptor blocker losartan would improve ambulatory short-term BP variability in hypertensive patients on hemodialysis. Method 40 hypertensive patients on hemodialysis therapy were randomly assigned to the losartan treatment group (n=20) or the control treatment group (n=20). At baseline and 6 and 12 months after the treatment, 24-h ambulatory BP monitoring was performed. Echocardiography and measurements of brachial-ankle pulse wave velocity (baPWV) and biochemical parameters were also performed before and after therapy. Results After 6- and 12-months of treatment, nighttime short-term BP variability, assessed on the basis of the coefficient of variation of ambulatory BP, was significantly decreased in the losartan group, but remained unchanged in the control group. Compared with the control group, losartan significantly decreased left ventricular mass index (LVMI), baPWV, and the plasma levels of brain natriuretic peptide and advanced glycation end products (AGE). Furthermore, multiple regression analysis showed significant correlations between changes in LVMI and changes in nighttime short-term BP variability, as well as between changes in LVMI and changes in the plasma levels of AGE. Conclusion These results suggest that losartan is beneficial for the suppression of pathological cardiovascular remodeling though its inhibitory effect on ambulatory short-term BP variability during nighttime.

Renal Haemodynamics and Plasma Renin in Patients with Essential Hypertension

1976 ◽  
Vol 50 (5) ◽  
pp. 409-414 ◽  
Author(s):  
E. B. Pedersen ◽  
H. J. Kornerup
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Vascular Resistance ◽  
Plasma Renin ◽  
Renal Vascular Resistance ◽  
Control Group ◽  
Hypertensive Patients ◽  
Control Subjects ◽  
Hypertensive Group ◽  
Renal Vascular

1. Blood pressure, glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured in twenty-three patients with essential hypertension and in twenty-one control subjects. Plasma renin concentration was measured in all the hypertensive patients and in fifteen control subjects. 2. GFR and RPF were similar in the hypertensive group and in the control group, whereas the renal vascular resistance was significantly higher in the hypertensive patients. GFR and RPF decreased with increasing blood pressure in both groups. Increasing age induced a further reduction in GFR and RPF in the control subjects but not in the hypertensive patients. 3. Plasma renin concentration in the hypertensive group did not differ from that in the control subjects. The concentration was not correlated to age in either the hypertensive or normal group. 4. Plasma renin index was positively correlated to GFR and RPF and inversely correlated to filtration fraction and renal vascular resistance. 5. It is concluded that GFR and RPF depend on blood pressure in both hypertensive patients and normotensive control subjects. In contrast to the control group, the age effect was negligible in the hypertensive group. It is suggested that renin release depends on changes in renal vascular resistance in the arterioles at the glomerulus and the results support the baroreceptor theory of renin release.

EFEKTIVITAS PEMBERIAN HYDROTHERAPI RENDAM KAKI PADA PENDERITA HIPERTENSI DI BANJAR SRI MANDALA, KELURAHAN DAUHWARU KABUPATEN JEMBRANA

2019 ◽  
Vol 10 (01) ◽  
pp. 33-44
Author(s):  
N.L.G. Sudaryati ◽  
I P. Sudiartawan ◽  
Dwi Mertha Adnyana
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Reduce Blood Pressure ◽  
Second Grade ◽  
Control Group ◽  
Hypertensive Patients ◽  
First Category

The aim of the study was to determine the effectiveness of giving hydrotherapi foot soak in hypertensive patients. The study was conducted with one group pretestposttest design without a control group by measuring blood pressure (pretest) before being given an intervention in the form of foot soak hydrotherm against 15 people with hypertension in Banjar Sri Mandala, Dauhwaru Village, Jembrana Subregency. Then do the blood pressure measurement again (posttest) after finishing the intervention. After the study was completed, the results showed that before the hydrotherapi foot bath intervention, there were 0% of patients classified as normal, 13.32% in prehypertension category, 60.08% in hypertension category I and 26.60% in hypertension category II. After the intervention was given, there were 13.32% of the patients classified as normal, 66.68% in the prehypertension category, 20.00% in the first category of hypertension and no patients belonging to the second grade hypertension category. There is a decrease of 20-30 mmHg for systolic blood pressure and 0-10 mmHg for diastolic blood pressure after intervention. Based on the results of the study it can be concluded that the hydrotherapi foot bath is effectively used to reduce blood pressure in hypertensive patients in the Banjar Sri Mandala, Dauhwaru Village, Jembrana District.

Feedback based on health advice via tracing bracelet and smartphone in the management of Blood Pressure among hypertensive patients: A Community-based RCT Trial in Chongqing, China (Preprint)

2020 ◽  
Author(s):  
Yong Zhang ◽  
Yang Tao ◽  
Yun Zhong ◽  
Jacqueline Thompson ◽  
Jamal Rahmani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Control Group ◽  
Community Settings ◽  
Post Intervention ◽  
Attrition Rates ◽  
Hypertensive Patients ◽  
Professional Health ◽  
Group A ◽  
And Control ◽  
Study Intervention

UNSTRUCTURED Lifestyle interventions have been recognised as a line treatment of non-communicable diseases. The aimed of this study was to evaluate a bespoke mHealth approach to delivers personalised feedback to improve blood pressure and weight for hypertensive patients in community settings. A total of 307 participants, 50 from each community, were expected to be in the intervention or control group. A professional health facilitator was assigned for each of the 6 communities. The primary outcomes of the study are the reduction in blood pressure and weight at baseline and post-intervention. Of 307 recruited,192 (62.5%) participants completed the study (intervention: 104 and control: 88). There was no difference in attrition rates between the two groups (33.5%vs41.9%, p=0.291). After 6-months of intensive feedback intervention through mHealth approach, patients had better blood pressure, weight, and BMI compared with control. People who were adherent to the intervention demonstrated a clinical benefit with regards to weight and blood pressure.

Effects of 12 weeks of aerobic versus combined aerobic plus resistance exercise training on short-term blood pressure variability in patients with hypertension

2021 ◽  
Vol 130 (4) ◽  
pp. 1085-1092
Author(s):  
Giuseppe Caminiti ◽  
Ferdinando Iellamo ◽  
Annalisa Mancuso ◽  
Anna Cerrito ◽  
Matteo Montano ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Exercise Training ◽  
Resistance Exercise ◽  
Aerobic Exercise ◽  
Blood Pressure Variability ◽  
Short Term ◽  
Resistance Exercise Training ◽  
Hypertensive Patients ◽  
Combined Exercise ◽  
Resistance Exercises

Combined exercise training (CT) including aerobic plus resistance exercises could be more effective in comparison with aerobic exercise (AT) alone in reducing blood pressure variability (BPV) in hypertensive patients. We report that CT was indeed more effective than AT in reducing short-term BPV, and both exercise modalities reduced BP levels to the same extent. CT appears to be a more appropriate exercise modality if the objective is to reduce BPV in addition to BP levels.

scholarly journals Comparing the Apelin Level in Hypertensive Patients Who Received Hypertension Drugs

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Mina Hemmati ◽  
Fatemeh Abharzanjani ◽  
Tooba Kazemi ◽  
Fateme Estanesti
Keyword(s):  
Blood Pressure ◽  
Case Control Study ◽  
Pressure Control ◽  
Control Group ◽  
Serum Samples ◽  
Hypertensive Patients ◽  
Amlodipine Group ◽  
The Mean ◽  
Plasma Apelin ◽  
Control Study

Background: Apelin, an adipokine secreted from adipose tissue, plays an important role in regulating blood pressure and hypertension. Objectives: The current study aimed to compare the plasma Apelin level in hypertensive patients under treatment with amlodipine, losartan, and amlodipine + losartan. Methods: In this case-control study, the serum level of Apelin was compared in four groups of (A) Healthy subjects (n = 31); (B) Hypertensive patients, received amlodipine (n = 31); Hypertensive patients, received losartan (n = 45); and patients (n = 33) that received amlodipine and losartan. Apelin level in serum samples was measured using Human Apelin ELISA Kit according to the manufacturers’ instructions. Data were analyzed using SPSS version 19 (Chicago: SPSS Inc.), at the significant level of α = 0.05. Results: The mean blood level of Apelin in the control group and groups receiving amlodipine, losartan, and amlodipine + losartan was 366.16 ± 36.04, 247.19 ± 27.77, 282.93 ± 47.08, and 289.84 ± 32.20 g/dl, respectively. Losartan + amlodipine group had a higher level of Apelin compared with amlodipine alone (P < 0.05). Conclusions: This study demonstrated that Apelin has a definite protective effect in preventing hypertension. Also, according to the results, the renin-angiotensin-aldosterone system inhibitors, such as losartan, caused a higher increase in the Apelin, resulting in better blood pressure control.

Effects of Confounding Factors on Blood Pressure in Hypertensive Patients: A Cross Sectional Study

2021 ◽  
Author(s):  
Emrah Ersoy ◽  
Cuneyt Ardic
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Control Group ◽  
Poor Sleep ◽  
Study Group ◽  
Confounding Factors ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Significant Difference

Abstract Background Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral in hypertensive patients. ObjectiveThe aim of this study is to investigate confounding factors in hypertensive patients who have poor blood pressure control.DesignThis study was designed as a cross-sectional study.ParticipantsOur sample was 407 patients with hypertension in Rize, a Northern city in the Black Sea Region of Turkey. In study group, there were 207 hypertensive patients who had admission to emergency department due to high blood pressure. In control group, there were 200 hypertensive patients visiting family physician,who defined themselves as having regulated blood pressure over the past six months.Main MeasuresPatients completed the questionnaire including sociodemographic data, lifestyle behaviors, health risks and confounding factors via the face-to-face interview method. Key ResultsOf the hypertensive patients, 81.2% (n=168) of the study group and 34.0% (n=68) of the control group had confounding factors. There was a significant difference between the hypertensive patients of study and control group in terms of their confounding factors (p<0.001). When we asked the patients of study group questions to reveal their confounding factors, 21.3% (n=44) stated ‘anger’, 12.6% (n=26) ‘sadness’, 11.1% (n=23) ‘anxiety’, 10.6% (n=22) ‘depressed’, 9.2% (n=19) ‘unhealthy diet’, 7.2% (n=15) ‘fatigue and poor sleep quality’, and 3.9% (n=8) ‘irregular medication’. Mean systolic and diastolic blood pressure were significantly higher in hypertensive patients having confounding factors than those without confounding factors (p=0.001, p=0.001, respectively). Mean systolic blood pressure of hypertensives who stated their confounding factor as ‘anger’ was significantly higher than those the remaining groups (p<0.001).ConclusionsThis study has shown that confounding factors impair blood pressure control in patients with hypertension. Confounding factors should be kept in mind and revealed in case of poor blood pressure control in hypertensive patients.

scholarly journals Fructose Consumption Contributes to Hyperinsulinemia in Adolescents With Obesity Through a GLP-1–Mediated Mechanism

2019 ◽  
Vol 104 (8) ◽  
pp. 3481-3490 ◽  
Author(s):  
Alfonso Galderisi ◽  
Cosimo Giannini ◽  
Michelle Van Name ◽  
Sonia Caprio
Keyword(s):  
Glucose Tolerance ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Cell Function ◽  
Insulin Response ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Double Blind ◽  
Obesity And Diabetes ◽  
Glucose Ingestion

Abstract Context The consumption of high-fructose beverages is associated with a higher risk for obesity and diabetes. Fructose can stimulate glucagon-like peptide 1 (GLP-1) secretion in lean adults, in the absence of any anorexic effect. Objective We hypothesized that the ingestion of glucose and fructose may differentially stimulate GLP-1 and insulin response in lean adolescents and adolescents with obesity. Design We studied 14 lean adolescents [four females; 15.9 ± 1.6 years of age; body mass index (BMI), 21.8 ± 2.2 kg/m2] and 23 adolescents with obesity (five females; 15.1 ± 1.6 years of age; BMI, 34.5 ± 4.6 kg/m2). Participants underwent a baseline oral glucose tolerance test to determine their glucose tolerance and estimate insulin sensitivity and β-cell function [oral disposition index (oDIcpep)]. Eligible subjects received, in a double-blind, crossover design, 75 g of glucose or fructose. Plasma was obtained every 10 minutes for 60 minutes for the measures of glucose, insulin, and GLP-1 (radioimmunoassay) and glucose-dependent insulinotropic polypeptide (GIP; ELISA). Incremental glucose and hormone levels were compared between lean individuals and those with obesity by a linear mixed model. The relationship between GLP-1 increment and oDIcpep was evaluated by regression analysis. Results Following the fructose challenge, plasma glucose excursions were similar in both groups, yet the adolescents with obesity exhibited a greater insulin (P &lt; 0.001) and GLP-1 (P &lt; 0.001) increase than did their lean peers. Changes in GIP were similar in both groups. After glucose ingestion, the GLP-1 response (P &lt; 0.001) was higher in the lean group. The GLP-1 increment during 60 minutes from fructose drink was correlated with a lower oDIcpep (r2 = 0.22, P = 0.009). Conclusion Fructose, but not glucose, ingestion elicits a higher GLP-1 and insulin response in adolescents with obesity than in lean adolescents. Fructose consumption may contribute to the hyperinsulinemic phenotype of adolescent obesity through a GLP-1–mediated mechanism.

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