title: Carotid artery stiffness is related to hyperinsulinemia and insulin-resistance in middle-aged, non-diabetic hypertensive patients.
abstract: OBJECTIVE
  Glycometabolic abnormalities are frequently found in hypertension and could affect the mechanical properties of carotid arteries. The aim of the study was to investigate the relationship of glucose tolerance, plasma insulin, and insulin sensitivity with carotid distensibility in middle-aged, non-diabetic hypertensive patients free of cardiac and vascular complications.
  
  
  RESULTS
  In 93 patients with grade 1-2, uncomplicated, primary hypertension and 68 matched normotensive controls we measured plasma glucose and insulin at fast and after an oral glucose load (OGTT), calculated the HOMA-index as a marker of insulin sensitivity, and assessed distensibility of common carotid arteries by B-mode ultrasonography. Hypertensive patients were hyperinsulinemic and insulin-resistant as compared to normotensive controls. Hypertensive patients with impaired fasting glucose and/or impaired glucose tolerance had comparable distensibility of carotid arteries. Patients with decreased carotid distensibility were older and had higher body mass, fasting and post-OGTT plasma insulin, HOMA-index, and carotid IMT than the remaining patients, but no differences in glycated hemoglobin, and fasting or post-OGTT plasma glucose. Carotid coefficient of distensibility was inversely related and β-stiffness directly related with fasting and post-OGTT plasma insulin, and HOMA-index. Multivariate logistic regression showed that age and post-OGTT plasma insulin levels predicted carotid artery stiffening independent of body mass index, sex, blood pressure, and plasma glucose levels.
  
  
  CONCLUSIONS
  The study demonstrates that decreased insulin sensitivity and the related hyperinsulinemia but not hyperglycemia could contribute to carotid artery stiffening in middle-aged, non-diabetic hypertensive patients free of cardiovascular complications.
authors.affiliation: Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, 33100 Udine, Italy; Department of Cardiology, Medical University of Graz, Graz, Austria. Electronic address: cristiana.catena@uniud.it.
authors.forename: C
authors.initials: C
authors.lastname: Catena
authors.affiliation: Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, 33100 Udine, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Colussi
authors.affiliation: Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, 33100 Udine, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Frangipane
authors.affiliation: Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, 33100 Udine, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Russo
authors.affiliation: Department of Cardiology, Medical University of Graz, Graz, Austria.
authors.forename: N D
authors.initials: ND
authors.lastname: Verheyen
authors.affiliation: Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, 33100 Udine, Italy.
authors.forename: L A
authors.initials: LA
authors.lastname: Sechi
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000503:physiopathology*; D006973:Hypertension / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D059289:Vascular Stiffness
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Carotid artery distensibility; Glucose; Glycated hemoglobin; HOMA-index; Insulin; Oral glucose tolerance test