[Biological characteristics of arterial systolic hypertension in relation to the degree of obesity in a middle aged active population].
It is well known that mean blood pressure (BP) is higher in obese subjects. However, the nature of the relationships between hypertension and obesity is not fully understood; this concerns especially the role of carbohydrate metabolism and sympathetic activity. The aim of this study is to compare hypertensive (systolic BP > or = 160 mmHg) to normotensive men at different levels of body mass index (BMI). We analyzed data from the Paris Prospective Study I concerning 6,424 men aged 40-53 years at entry, who were not treated for hypertension, diabetes and had no sign of heart disease. The biological parameters were glucose and insulin levels, both assessed fasting (G0, I0) and two hours after a 75-g oral glucose load (G2, I2), free fatty acids and cortisol levels. Hypertensive subjects had significantly higher G0 and G2 levels in all BMI tertiles (p < 0.001). On the contrary, I0 was significantly higher only in the third BMI tertile, and the difference in I2 level between hypertensive and normotensive subjects increased with BMI. Free fatty acids level was significantly higher in hypertensives in all BMI tertiles, however, it showed a significant negative trend with BMI (p < 0.0001) which was not present in normotensives. Morning cortisol level showed the same tendency as well and the mean difference between hypertensive and normotensive men decreased with increasing BMI. In conclusion, (1) relative hyperglycemia is present in subjects with systolic hypertension at all BMI levels, while hyperinsulinemia is found only in the more corpulent ones, and (2) free fatty acids and cortisol levels are particularly elevated in lean hypertensive men.
Filipovsky
J
J
Service de médecine interne II, Hôpital universitaire, Plzen, République tchèquè.
Ducimetière
P
P
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D005230:Fatty Acids, Nonesterified / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D013599:Systole
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D006854:Hydrocortisone
Caractéristiques biologiques de l'hypertension artérielle systolique selon le degré d'obésité dans une population active d'âge moyen.