Increased insulin response to an oral glucose load in salt-sensitive (SS) patients with hypertension (EH)

AJH-APRIL 1995-VOL.8, NO.4,PART 2

162A ASH ABSTRACTS

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NOCTURNAL BLOOD PRESSURE INCREMENTS INDICATE FAST DECLINE INRENAL FUNCTION.

RETINOL-BINDING PROTEIN AND TRANSFERRIN IN URINE: NEW MAW'ERS OF RENAL FUNCTION IN ESSENTIAL HVPERTENSION7

J. Mehlsen2, L.J. Petersen', J.R. Petersen 2, S.D. Ladefoged', H.JE. Jensen', Dept. of Nephrology" Hvldovre Hospilial and Dept. ofClinical Physiolog:f2. FrederiksbergHospllal, Copenhagen, Denmark. Thearm ofthestudy was to measure the24hour ambulatory blood pressure profile inhypertensive patients with chronic renal failure, nnd correlate this profile to the rate of decline in renal function. Twenly patients wllh hypertension (blood pressure exceeding 140/95 mmH,,) and GFR lessthan 50mllmln participated. Ambulatory blood pressure was measured wllh a TAKEDA TM2421 monllor. GFR WllSmeasured as censtant Infu~jon ~lCr· EOTA·cleararlce. Onlyseveo outof20patients had anormal noctumal decline In blood pressure (darined as a reduction of mora than 10% of
LE Bang. J Holm and TL Svendsen, Naestved andNykocbing Falster Hospitals, Denmark. We studied the24 urinar;J ex(;retion vI' retinol.binding pro/cin (RBP). lransferrin,l\lbumin and immunoglobulin 0 (lgO) in individuals with essenlilll hypertension, white coal hypertension, hypertension withWhite coat response anda nonnolensi ve group. In 58individuals we measured the24hour ambulatory blood pressure CAMSP) onworking dayR. The individuals could be divided into four groups: 17hypertensives (diastolic office pressure anddaytime diastolic AMBP ~ 95rnmHg). II hypertensives with a white coal response tea difference between office anddiastolic AMBP ~ 10mmHS, 14white COllt hYJIertensivcs (diastolic office pressure ~ 95mrnHg anddaytime diastolic AMBP S 90 mmHg) and16nonnotensives. The four groups were matched with respect toageandgender. TheconeclltrllHons ofscreatinine were nOlmal andbody mass indi~s wer,' comparable. Daytime AMBP values were (lI1edilln, mmHg): hypertensires 158f105, hypertensives with •t:'litecoat response 1641104 mr.IH8. while "Ollt hypertensives 141/83 lind nonnotensives 123175. Wedetermined t~e 24 hour urinary excretions ofalbumin (M,.. 65kDA). transferrin (M,.. SOWa) andIgO eM, - 150lcDa). all markers of glomerular dy5function, and RBP (M... 2lkDa), a marker of impaired proximallubular Iunetion, with immuntiChemical methods. We found a significantlv higher excretion orRDP in hypertensive patienls with (p
Key Words: Esscntial hypertension, white coat hypertension, renal function. 24hour ambulatory blood pressure.

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ACUTE PROSTACLANDINS AND SYMPATHETIC ACTIVITY CHANGES DUE TO AMINO ACIDS LOAD IN ESSENTIAL HYPERTENSION S.Collone,A. Vadalil,N, Paaepi nlo,C.Zagarri go,C.Carollo, O.Ccr.lsola* Chair t,f Internal Medicine and Hypertension Center, University or Palermo, IUlly Thc mechanisms, operated by amino acids. involved in the modulalionof renal tubular funclioll and in glomerular hcmodynumics, arc slill debated, In order to evaluate changes in some faclOrs which mr:)' be involved in these phenomena. westudied 10cssenuul hypcnensivcs (EH) without evidences of clinical nephropathy (Cs<1 mg'1!.); the EHs underwent an acute amino acids (AAs) load (lsopuramine 5(X) ml/2h L\'.) , and both in basal condition andonehour
Key Words:

Prmtaglandins. Catccholllmines. Amino Add.~

INCREASED INSULIN RESPONSE TOANORAL GLUCOSE LOAD IN SALT·SEN8rUVE (8S) PA11ENTS WITH HYPERTENSION (Ell) S Bianchi, R Bigazzi, G Baldari, and VM Oampese, Division Nephrol, Livomo, Italy, and Univ. of Southern California, Los Angeles, CA. Hyperinsulinemia, and insulin resistance have been described in EH. Some have suggested that hyperinsulinemia may raise blood pessure (BP) via Na+ retention and stimulation of the sympathetic nervous system. In this study, we have tested whether an association exists between 5S and hyperinsulinemia h";- EH. To determine saltsensitivity, patients were given a diet containing a low (10 mEq/day) Na+ intake for 1 week followed by a high (250 mEq/day) Na+ intake for 1 more week. Twenty-nine patients were classified as SS, and 23 as salt-resistant (SR). All patients underwent an oral glucose load test (75 g). Baseline serum insulin and glucose in SS (96t9.1 pmollL and 5.0±O.09 mmollL, respectively) were not different than in SR (86.B±l2.3 pmollL and 4.6±O.09 mmollL, respectively). The area-under-the curve (AUC) of glucose in SS was higher than in SR (900t26.4 and 81Ot29.1 mmollLx2 hours, respectively). The AUC of insulin also was greater «P
Hypertension, Insulin, Salt-sensitivity, Oral glucose tolerance test.