Role of insulin resistance in essential hypertension

IntroductionHypertension is a major health problem with widespread and sometimes devastating consequences. To confirm the role of insulin resistance and hyperinsulinemia in the pathogenesis of essential hypertension, many studies have been conducted. As no data in this regard are available from our part of the world, our study focuses onestablishing the role of insulin resistance and compensatory hyperinsulinemia in the hypertensive Kashmiri population. Materials and methodsThe study was carried out at a tertiary care hospital from December 2010 to October 2012. A total of 100 individuals aged above 18 years were recruited; 50 were newly detected cases of essential hypertension and 50 were age-matched and sex-matched normal healthy individuals. Serum insulin concentration was measured using an insulin electrochemiluminescence immunoassay. Insulin resistance was determined by HOMA-IR (homeostasis model assessment of insulin resistance). A comparison and contrast analysis of data was carried out using standard statistical methods. ResultsStatistically, the difference in mean fasting blood glucose between the two study groups was significant (P=0.0001). The mean fasting serum insulin level was 15.32±13.76 µU/ml in cases and 8.01±4.08 µU/ml in controls (reference range 2.6–24.9 µU/ml); the difference was statistically significant (P=0.001). The mean value of HOMA-IR in cases was 3.81±3.42 as compared with controls with a mean HOMA-IR value of 1.76±0.93. This difference was statistically significant (P=0.0001). ConclusionEssential hypertension is significantly associated with higher mean fasting insulin levels and insulin resistance. Hyperinsulinemia has a possible role in the pathophysiology of essential hypertension with insulin resistance being the likely predominant mechanism.