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Am J Physiol Endocrinol Metab 274: E403-E409, 1998;
0193-1849/98 $5.00
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Vol. 274, Issue 3, E403-E409, March 1998

Insulin sensitivity is associated with blood pressure response to sodium in older hypertensives

Donald R. Dengel, Robert V. Hogikyan, Michael D. Brown, Scott G. Glickman, and Mark A. Supiano

Division of Geriatric Medicine, Department of Internal Medicine, and the Geriatric Research, Education and Clinical Center, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan 48105

The purpose of this study was to determine whether sodium-resistant hypertensives are more insulin resistant and whether dietary sodium restriction improves insulin sensitivity in older hypertensives. Insulin sensitivity was assessed by a frequently sampled intravenous glucose tolerance test to determine the insulin sensitivity index (SI) after 1 wk each of low- (20 mmol · l-1 · day-1) and high- (200 mmol · l-1 · day-1) sodium diets in 21 older (63 ± 2 yr) hypertensives. Subjects were grouped on the difference in mean arterial blood pressure (MABP) between diets [sodium sensitive (SS): >= 5-mmHg increase in MABP on the high-sodium diet (n = 14); sodium resistant (SR): <5-mmHg increase in MABP on the high-sodium diet (n = 7)]. There was no dietary sodium effect on fasting plasma insulin or SI. An analysis of variance indicated a significant (P = 0.0002) group effect, with SS individuals having lower fasting plasma insulins on the low- (13 ± 2 vs. 27 ± 3 µU/ml) and high- (12 ± 2 vs. 22 ± 3 µU/ml) sodium diets compared with SR individuals. Similarly, there was a significant (P = 0.0002) group effect in regard to SI, with SS individuals having significantly higher SI on the low- (3.26 ± 0.60 vs. 0.91 ± 0.31 µU × 10-4 · min-1 · ml-1) and high- (3.45 ± 0.51 vs. 1.01 ± 0.30 µU × 10-4 · min-1 · ml-1) sodium diets compared with SR individuals. We conclude that SR individuals exhibit a greater degree of insulin resistance than SS individuals and that dietary sodium restriction fails to improve insulin sensitivity regardless of sodium sensitivity status.

aging


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