Insulin-induced hypotension and neurogenic orthostatic hypotension.
Insulin-induced hypoglycemia induced a fall in blood pressure (BP) in patients with idiopathic orthostatic hypotension (IOH) and multiple system atrophy (MSA), but not in control subjects. Only in IOH was there a correlation between plasma norepinephrine (NE) levels and maintenance of BP during the test. The hypotension was not affected by pretreatment with propranolol. Hypotension during insulin-induced hypoglycemia is manifested in patients who lack an adequate NE response. The hypotension, however, may be due to a central action of insulin because not all MSA patients with impaired NE release become hypotensive.
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002493:Central Nervous System Diseases / Q000150:complications*; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate; D006801:Humans; D007022:Hypotension / Q000139:chemically induced* / Q000503:physiopathology; D007024:Hypotension, Orthostatic / Q000209:etiology* / Q000503:physiopathology; D007328:Insulin / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011433:Propranolol / Q000494:pharmacology
D001786:Blood Glucose; D007328:Insulin; D011433:Propranolol; D009638:Norepinephrine; D004837:Epinephrine