The Research Of The Relationship Between Insulin Resistance And Cardiac Structure And Function In Essential Hypertensive Patients

Objective: To observe the relationship between insulin resistance and cardiac structure and function in essential hypertensive patients.Method: We retrospectively studied 55 nondiabetic subjects with essential hypertension from March, 2003 to March 2004 at the emergency center of Tianjin Medical University General Hospital. The control group were normal persons. All had 24-hour noninvasive ambulance blood pressure (ABP) monitoring, 75-g oral glucose tolerance test (OGTT) and Echocardiagraphic study. We determined fasting glucose ,fasting plasma insulin and postload glucose and plasma insulin 2 hours after in taking 75-g glucose. Insulin resistance was estimated by the homeostasis model assessment (HOMA1R). After the ABP and Echocardiagrapy examination we determined the average systolic BP, average diastolic BP, left ventricular mass (LVM), relative wall thickness (RWT) and the ratio of the early filling phase peak transmitral flow velocity (peak E) with the late diastolic filling phase peak transmitral flow velocity (peak A).Result: It is different of fasting plasma insulin, postload 2-hour plasma insulin, HOMA1R between hypertensive patients and control group. The fasting plasma insulin, postload 2-hour plasma insulin, HOMA1R, triglycerine, interventricular spetum (IVS), left ventricular end-diastolic diameter (LVEED), LVM and LVM index are also different between fatty and normal weight persons. LVM showed a positive association with 24-hour average diastolic BP, 24-hour average systolic BP, fasting plasma insulin, postload 2-hour plasma insulin and HOMA1R. RWT was associated with 24-hour average diastolic BP, 24-hour average systolic BP, fasting plasma insulin, postload 2-hour plasma insulin and HOMA1R positively.-3-The ratio E/A was associated with postload 2-hour plasma insulin, 24-houraverage systolic BP and age negatively.Conclusion: Insulin resistance induced essential hypertension, and it is apowerful independent determinants of LVM, RWT and E/A ratio. So insulinresistance promoted left ventricular hypertrophy and impaired left ventriculardiastolic function.