Microalbuminuria in never-treated hypertensives: lack of relationship to hyperinsulinemia and genetic predisposition to hypertension.
We evaluated the relationship of microalbuminuria to hyperinsulinemia and family history of hypertension in 92 never-treated essential hypertensives (mean 24-h blood pressure >140 or 90 mm Hg), with positive (F+) or negative (F-) family history of hypertension: 31 had microalbuminuria (MA+) (urinary albumin excretion [UAE], 30 to 300 mg/24 h) and 61 had normal (<30 mg/24 h) UAE (MA-). Glucose and insulin values before and 30, 60, 90, and 120 min after an oral glucose load were measured together with an index of peripheral insulin activity (10(4)/ insulin x glucose values at glucose peak). Subjects with and without microalbuminuria did not differ with regard to age, sex, body mass index, and 24-h heart rate, whereas 24-h, daytime, and nighttime systolic and diastolic blood pressure were significantly higher in MA+ than MA- patients. The prevalence of positive family history of hypertension was similar between MA+ and MA-, as were fasting and stimulated glucose and insulin values and the index of peripheral insulin activity. Subdividing the patients on the basis of family history of hypertension (59 F+, 33 F-) UAE was not significantly different between F+ and F-. UAE did not correlate with glucose and insulin parameters. From our results, in never-treated hypertensives, microalbuminuria is associated with higher blood pressure values, but is related neither to genetic predisposition to hypertension, nor to hyperinsulinemia; therefore, impaired insulin sensitivity and microalbuminuria are two components of the hypertensive syndrome, largely independent of each other.
Grandi
A M
AM
Department of Clinical and Biological Sciences, Faculty of Medicine, University of Insubria, Varese, Italy. amgrandi@libero.it
Santillo
R
R
Zanzi
P
P
Broggi
R
R
Imperiale
D
D
Colombo
S
S
Bertolini
A
A
Jessula
A
A
Selva
E
E
Guasti
L
L
Venco
A
A
D000328:Adult; D000419:Albuminuria / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics*; D001786:Blood Glucose; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D005192:Family Health; D005260:Female; D005951:Glucose Tolerance Test; D006339:Heart Rate; D006801:Humans; D006946:Hyperinsulinism / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics*; D006977:Hypertension, Renal / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics*; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence
D001786:Blood Glucose; D007328:Insulin