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Citations to this article

Hyperinsulinemia. A link between hypertension obesity and glucose intolerance.
M Modan, … , A Shitrit, Z Fuchs
M Modan, … , A Shitrit, Z Fuchs
Published March 1, 1985
Citation Information: J Clin Invest. 1985;75(3):809-817. https://doi.org/10.1172/JCI111776.
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Research Article Article has an altmetric score of 13

Hyperinsulinemia. A link between hypertension obesity and glucose intolerance.

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Abstract

Hypertension and glucose intolerance, determined in a random population sample (n = 2,475), showed a highly significant (P less than 0.001) association from the mildest levels of both conditions, independent of the confounding effects of age, sex, obesity, and antihypertensive medications. Summary rate ratios for hypertension were 1.48 (1.18-1.87) in abnormal tolerance and 2.26 (1.69-2.84) in diabetes compared with normal tolerance. Altogether, 83.4% of the hypertensives were either glucose-intolerant or obese--both established insulin-resistant conditions. Fasting and post-load insulin levels in a representative subgroup (n = 1,241) were significantly elevated in hypertension independent of obesity, glucose intolerance, age, and antihypertensive medications. The mean increment in summed 1- and 2-h insulin levels (milliunits per liter) compared with nonobese normotensives with normal tolerance was 12 for hypertension alone, 47 for obesity alone, 52 for abnormal tolerance alone, and 124 when all three conditions were present. The prevalence of concentrations (milliequivalents per liter) of erythrocyte Na+ greater than or equal to 7.0, K+ less than 92.5, and plasma K+ greater than or equal to 4.5 in a subsample of 59 individuals with all combinations of abnormal tolerance obesity and hypertension was compared with those in 30 individuals free of these conditions. Altogether, 88.1% of the former vs. 40.0% of the latter group presented at least one of these three markers of internal cation imbalance (P less than 0.001). We conclude that insulin resistance and/or hyperinsulinemia (a) are present in the majority of hypertensives, (b) constitute a common pathophysiologic feature of obesity, glucose intolerance, and hypertension, possibly explaining their ubiquitous association, and (c) may be linked to the increased peripheral vascular resistance of hypertension, which is putatively related to elevated intracellular sodium concentration.

Authors

M Modan, H Halkin, S Almog, A Lusky, A Eshkol, M Shefi, A Shitrit, Z Fuchs

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Total citations by year

Year: 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1982 1967 Total
Citations: 2 3 5 7 15 15 11 14 13 8 15 13 19 117 9 16 19 25 23 18 25 26 25 26 43 38 61 46 42 60 68 81 67 68 38 27 38 21 8 1 1 1177
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Citations to this article in year 2004 (25)

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Prevention of Type 2 Diabetes Mellitus Through Inhibition of the Renin-Angiotensin System:
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Progress in Cardiovascular Diseases 2004
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Obesity and metabolism 2004
Pathogenesis of Hypertension in Diabetes
SN Stas, FA El-Atat, JR Sowers
Reviews in Endocrine and Metabolic Disorders 2004

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