Negative correlation between fasting plasma insulin and ambulatory blood pressure in patients on chronic hemodialysis.
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Biomedical subjects
K Narkiewicz
Publications and source records attributed to K Narkiewicz.
Increased urinary C-peptide and albumin excretion in juvenile borderline hypertensives.
The study was designed to evaluate the urinary excretion of C-peptide and albumin, and urinary N-acetyl-beta-D-glucosaminidase (NAG) activity in juvenile borderline hypertensives. The second aim was to examine the relationship between these variables and ambulatory blood pressure level and variability. The study group consisted of 21 non-obese males consecutively chosen from patients with borderline hypertension, defined by sphygmanometer readings, examined in our outpatient clinic. All subjects collected separately their day-time and night-time urines during the period of ambulatory blood pressure monitoring. In 16 patients, who were considered to have "sustained" borderline hypertension, both 24-h urinary C-peptide excretion and 24-h UAE were significantly increased in comparison to those of the controls, while NAG activity did not differ significantly between the two groups. UAE was significantly lower at night than during the day in both borderline hypertensives and controls. Twenty-four-hour UAE in borderline hypertensives correlated significantly with the ambulatory blood pressure variability, but not with the average blood pressure level. These results suggest that the 24-h insulin secretion rate estimated by means of urinary C-peptide excretion is significantly increased in "sustained" borderline hypertensives. Elevated UAE in juvenile borderline hypertensives can be explained by a possible direct effect of systemic blood pressure variability on albuminuria.
Acetylglucosaminidase↗
[Circadian rhythm of blood pressure and heart rate in hypertension with type 2 diabetes mellitus].
Hypertension is an important risk factor for cardiovascular complications of diabetes. Most of the studies performed in diabetics so far, however, have dealt with the assessment of blood pressure by traditional sphygmomanometry. In order to investigate the circadian pattern of blood pressure and heart rate in patients with different categories of glucose tolerance, we performed ambulatory blood pressure monitoring in 28 obese hypertensives without clinical nephropathy divided in two groups. Group A consisted of 14 hypertensive males with type 2 diabetes mellitus (mean age 49.7 +/- 7.1 years, mean duration of diabetes 4.0 +/- 2.9 years); group B consisted of 14 hypertensive males with normal glucose tolerance according to National Diabetes Data Group (mean age 47.2 +/- 7.1 years). There was no significant difference in casual blood pressure (151.4/104.8 in group A versus 148.5/104.2 mmHg in group B). Ambulatory blood pressure monitoring revealed significantly higher systolic blood pressure in group A during the day (162.2 +/- 12.1 vs 152.1 +/- 9.0 mmHg in group B, P < 0.05) and at night (141.0 +/- 13.2 vs 125.5 +/- 12.5 mmHg in group B, P < 0.005). That suggests that casual readings underestimate systolic blood pressure as a predictor for macrovascular events in type 2 diabetics. The decline in nocturnal heart rate was significantly lower in group A (11.2 +/- 5.2 min-1) in comparison to group B (16.9 +/- 7.0 min-1; P < 0.05) suggesting reduced parasympathetic tone at night in diabetic patients. We conclude that type 2 diabetes has significant influence on systolic blood pressure and heart rate 24-h profiles even in patients without diabetic nephropathy.
Blood Pressure↗
Relationship between fasting plasma insulin and ambulatory blood pressure in young, non-obese normotensive subjects.
In order to investigate the relationship between ambulatory blood pressure values and fasting plasma insulin, non-invasive, 24-h blood pressure monitoring was performed in 32 young normotensive males. Systolic and diastolic blood pressures were averaged for awake and asleep periods. Fasting plasma insulin levels correlated significantly with both asleep (r = 0.61; P less than 0.001) and awake (r = 0.44; P less than 0.02) systolic blood pressure, but not with casual systolic blood pressure (r = 0.27). There were no significant associations between awake, asleep and casual diastolic blood pressure, and fasting plasma insulin levels (r = 0.15, 0.05 and 0.21, respectively). These results support the hypothesis that insulin may be a physiological determinant of blood pressure.
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[Spectrum analysis of heart rate. A method of studying the role of the autonomic nervous system in the regulation of blood circulation].
Spectral analysis of heart rate variability has recently been shown to be a reliable noninvasive test for quantitative assessment of cardiovascular automatic regulatory responses. In 12 ambulant normotensive healthy young males (mean age 23 +/- 1 years) after a period of 10 min. for stabilisation, a continuous ecg recording (lead CM-5) for 8 min. was obtained in the supine and standing position, with a controlled respiration rate 15/min. Power spectrum of 512 point time series (R-R intervals) in both positions was calculated using a fast Fourier transform-based window periodogram method. Based upon results from the literature the power spectrum analysis was performed on two components: low frequency LF (0.05-0.15 Hz) and high frequency HF (0.15-0.50 Hz). Mean R-R interval decreased on standing position from 0.79 +/- 0.10 s to 0.59 +/- 0.11 s (p less than 0.001). The ratio HF/LF in supine was 0.63 +/- 0.70 and on standing position 2.54 +/- 0.73 (p less than 0.001). The relative LF component of the total HR power spectrum increased from 22.8% +/- 12.1% to 42.9 +/- 14.4% (p less than 0.001) after changing the position from supine to standing, and the relative HF component decreased from 56.3 +/- 22.4% to 25.5 +/- 16.2 (p less than 0.001). The total power was significantly lower when standing in comparison to supine position (681 +/- 519 s2, 1188 +/- 963 s2 respectively, p less than 0.05). Our results suggest that heart rate fluctuations in supine position in normal men are mainly vagally determined (HF power spectrum component).(ABSTRACT TRUNCATED AT 250 WORDS)
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Interactive effect of heart rate and muscle sympathetic nerve activity on blood pressure.
BACKGROUND: Sympathetic traffic to the peripheral vasculature and sympathetic discharge to the heart have complementary effects on blood pressure. Although faster heart rates have been linked to higher blood pressures, the relationship between muscle sympathetic nerve activity (MSNA) and long-term regulation of blood pressure is not clear. We tested the hypothesis that MSNA and heart rate are linked to blood pressure levels in normotensive subjects. METHODS AND RESULTS: We studied normal young male (n=120) and female (n=48) subjects subdivided according to tertiles of heart rate and MSNA distributions. Systolic, diastolic, and pulse pressures were significantly different across the heart rate tertiles in male subjects, with the highest blood pressure values in the upper tertile of heart rate. No significant differences in blood pressure across the tertiles of MSNA were found. The relationship between MSNA and blood pressure, however, was affected by heart rate. MSNA did not influence blood pressure in the first and second heart rate tertiles. However, within the upper heart rate tertile, subjects with higher levels of MSNA had significantly higher systolic (P=0. 02) and pulse (P=0.004) pressures than subjects with lower levels of MSNA. In female subjects, blood pressure was not different across the tertiles of heart rate or MSNA. CONCLUSIONS: MSNA and heart rate have interactive effects on systolic blood pressure and pulse pressure in normotensive male but not female subjects. No relationship between MSNA and blood pressure or pulse pressure is evident in subjects with slower heart rate. In male subjects with faster heart rates, higher levels of MSNA are associated with higher systolic and pulse pressures.
Adult↗
[Evaluation of blood pressure changes and heart rate in young health men based on results of a 24-hour monitoring of pressure].
Systolic and diastolic blood pressures and heart rate were monitored in a group of 20 young healthy men for 24 hours. Period of time between 8 o'clock a.m. and 10 o'clock p.m. was treated as waking state whereas period of time from 12 p.m. to 6 a.m. as sleep phase. Mean value of systolic blood pressure for waking state was 124.6 +/- 7.6 mm Hg, and for sleep phase 110.4 +/- 11.5 mm Hg. (p < .001). Mean diastolic blood pressures were also significantly different (76.5 +/- 5.9 mm Hg and 63.8 +/- 7.7 mm Hg, respectively), the same concerns heart rate (79.6 +/- 6.4 and 63.0-7.2 min-1, respectively). In both cases p < .001. To evaluate dependence of heart rate on systolic blood pressure in waking state the following calculation was made: HR = 0.230 x systolic blood pressure +51.4 (r = 0.24; p < .001) whereas for sleep phase r did not reach a level of statistical significance (HR = 0.074 x systolic blood pressure + 53.9; r = 0.094). Single or even multiple measurements of the arterial blood pressure are not sufficient to evaluate circadian changes.
Adult↗
[Levels of insulin in serum during fasting and circadian blood pressure profile in young health men].
In order to investigate the relation of ambulatory blood pressure values to fasting plasma insulin, non-invasive 24-hour blood pressure monitoring was performed in 32 young normotensive males. Systolic and diastolic blood pressures were averaged for awake and asleep periods. Fasting plasma insulin levels correlated significantly with both asleep (r = 0.61; p < 0.001) and awake systolic blood pressures (r = 0.44; p < 0.02) but not with casual systolic blood pressure (r = 0.27). There were no significant associations of awake, asleep and causal diastolic blood pressures values with fasting plasma insulin levels (r = 0.15, 0.05 and 0.21, respectively). These results support the hypothesis that insulin may be a physiological determinant of blood pressure.
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Plasma insulin and blood pressure response to oral glucose tolerance test in young borderline hypertensives.
In order to evaluate whether borderline hypertension might be associated with hyperinsulinaemia, twenty non-obese borderline hypertensives and twenty matched normotensives underwent a standard oral glucose tolerance test and 24-h ambulatory blood pressure monitoring. Blood pressure, plasma glucose and insulin were measured at fasting and 15, 30, 60, 120 and 180 minutes after glucose load. Fasting plasma insulin was significantly higher in borderline hypertensives in comparison to normotensives (16.6 +/- 6.9 vs 12.4 +/- 4.2 mU/l; P < 0.05). Plasma insulin response estimated by the positive incremental area under the curve did not differ significantly between two groups but borderline hypertensives showed a larger interindividual difference. Decrease of systolic blood pressure after glucose load was significantly greater in borderline hypertensive subjects. Furthermore, blood pressure and plasma insulin relationship was different in borderline hypertensives compared to normotensives.
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