Capillary recruitment is impaired in essential hypertension and relates to insulin's metabolic and vascular actions

Erik H. Serné, Reinold O.B. Gans, Jan C. Ter Maaten, Piet M. Ter Wee, Ab J.M. Donker, Coen D.A. Stehouwer

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: In patients with essential hypertension, defects in both the metabolic and vascular actions of insulin have been described. Impaired microvascular function, a well-established abnormality in essential hypertension, may explain part of these defects. In the present study we investigated whether microvascular function is impaired in essential hypertension and relates to insulin's metabolic and vasodilatatory actions. Methods: We measured 24-h ambulatory blood pressure, capillary recruitment after arterial occlusion, and skin blood flow responses to iontophoresis of acetylcholine and sodium nitroprusside in 18 subjects with untreated essential hypertension and in 18 control subjects. Whole body insulin sensitivity and leg insulin-mediated vasodilatation were assessed with the hyperinsulinaemic clamp technique and plethysmography. Results: Hypertensive, as compared to normotensive, subjects had a decreased insulin sensitivity (0.8±0.3 vs. 1.7±0.6 mg kg-1 min-1 per pmol l-1; P<0.001), capillary recruitment after arterial occlusion (21.5±5.8 vs. 45.9±10.4%; P<0.001), acetylcholine-mediated vasodilatation (331±84 vs. 688±192%; P<0.001), and insulin-mediated vasodilatation (median 29.3 vs. 47.2%; P<0.05). Correlation analyses with adjustment for sex, age, body mass index and waist-to-hip ratio showed significant relationships of capillary recruitment after arterial occlusion with blood pressure (r=-0.68; P<0.01), insulin sensitivity (r=+0.55; P<0.01) and insulin-mediated vasodilatation (r=+0.51; P<0.05), which extended from the normotensive to the hypertensive range. Conclusion: Skin microvascular function is associated with blood pressure and insulin's metabolic and vasodilatatory actions, both in normotensive and hypertensive subjects. These findings offer a potential mechanistic explanation of the links among insulin resistance, impaired insulin-mediated vasodilatation and hypertension. (C) 2001 Elsevier Science B.V.

Original languageEnglish
Pages (from-to)161-168
Number of pages8
JournalCardiovascular Research
Volume49
Issue number1
DOIs
Publication statusPublished - 1 Jan 2001

Cite this

@article{bb4dea644acd487f9479ac215a8f2455,
title = "Capillary recruitment is impaired in essential hypertension and relates to insulin's metabolic and vascular actions",
abstract = "Objective: In patients with essential hypertension, defects in both the metabolic and vascular actions of insulin have been described. Impaired microvascular function, a well-established abnormality in essential hypertension, may explain part of these defects. In the present study we investigated whether microvascular function is impaired in essential hypertension and relates to insulin's metabolic and vasodilatatory actions. Methods: We measured 24-h ambulatory blood pressure, capillary recruitment after arterial occlusion, and skin blood flow responses to iontophoresis of acetylcholine and sodium nitroprusside in 18 subjects with untreated essential hypertension and in 18 control subjects. Whole body insulin sensitivity and leg insulin-mediated vasodilatation were assessed with the hyperinsulinaemic clamp technique and plethysmography. Results: Hypertensive, as compared to normotensive, subjects had a decreased insulin sensitivity (0.8±0.3 vs. 1.7±0.6 mg kg-1 min-1 per pmol l-1; P<0.001), capillary recruitment after arterial occlusion (21.5±5.8 vs. 45.9±10.4{\%}; P<0.001), acetylcholine-mediated vasodilatation (331±84 vs. 688±192{\%}; P<0.001), and insulin-mediated vasodilatation (median 29.3 vs. 47.2{\%}; P<0.05). Correlation analyses with adjustment for sex, age, body mass index and waist-to-hip ratio showed significant relationships of capillary recruitment after arterial occlusion with blood pressure (r=-0.68; P<0.01), insulin sensitivity (r=+0.55; P<0.01) and insulin-mediated vasodilatation (r=+0.51; P<0.05), which extended from the normotensive to the hypertensive range. Conclusion: Skin microvascular function is associated with blood pressure and insulin's metabolic and vasodilatatory actions, both in normotensive and hypertensive subjects. These findings offer a potential mechanistic explanation of the links among insulin resistance, impaired insulin-mediated vasodilatation and hypertension. (C) 2001 Elsevier Science B.V.",
keywords = "Blood flow, Capillaries, Endothelial function, Hypertension",
author = "Sern{\'e}, {Erik H.} and Gans, {Reinold O.B.} and {Ter Maaten}, {Jan C.} and {Ter Wee}, {Piet M.} and Donker, {Ab J.M.} and Stehouwer, {Coen D.A.}",
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Capillary recruitment is impaired in essential hypertension and relates to insulin's metabolic and vascular actions. / Serné, Erik H.; Gans, Reinold O.B.; Ter Maaten, Jan C.; Ter Wee, Piet M.; Donker, Ab J.M.; Stehouwer, Coen D.A.

In: Cardiovascular Research, Vol. 49, No. 1, 01.01.2001, p. 161-168.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Capillary recruitment is impaired in essential hypertension and relates to insulin's metabolic and vascular actions

AU - Serné, Erik H.

AU - Gans, Reinold O.B.

AU - Ter Maaten, Jan C.

AU - Ter Wee, Piet M.

AU - Donker, Ab J.M.

AU - Stehouwer, Coen D.A.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Objective: In patients with essential hypertension, defects in both the metabolic and vascular actions of insulin have been described. Impaired microvascular function, a well-established abnormality in essential hypertension, may explain part of these defects. In the present study we investigated whether microvascular function is impaired in essential hypertension and relates to insulin's metabolic and vasodilatatory actions. Methods: We measured 24-h ambulatory blood pressure, capillary recruitment after arterial occlusion, and skin blood flow responses to iontophoresis of acetylcholine and sodium nitroprusside in 18 subjects with untreated essential hypertension and in 18 control subjects. Whole body insulin sensitivity and leg insulin-mediated vasodilatation were assessed with the hyperinsulinaemic clamp technique and plethysmography. Results: Hypertensive, as compared to normotensive, subjects had a decreased insulin sensitivity (0.8±0.3 vs. 1.7±0.6 mg kg-1 min-1 per pmol l-1; P<0.001), capillary recruitment after arterial occlusion (21.5±5.8 vs. 45.9±10.4%; P<0.001), acetylcholine-mediated vasodilatation (331±84 vs. 688±192%; P<0.001), and insulin-mediated vasodilatation (median 29.3 vs. 47.2%; P<0.05). Correlation analyses with adjustment for sex, age, body mass index and waist-to-hip ratio showed significant relationships of capillary recruitment after arterial occlusion with blood pressure (r=-0.68; P<0.01), insulin sensitivity (r=+0.55; P<0.01) and insulin-mediated vasodilatation (r=+0.51; P<0.05), which extended from the normotensive to the hypertensive range. Conclusion: Skin microvascular function is associated with blood pressure and insulin's metabolic and vasodilatatory actions, both in normotensive and hypertensive subjects. These findings offer a potential mechanistic explanation of the links among insulin resistance, impaired insulin-mediated vasodilatation and hypertension. (C) 2001 Elsevier Science B.V.

AB - Objective: In patients with essential hypertension, defects in both the metabolic and vascular actions of insulin have been described. Impaired microvascular function, a well-established abnormality in essential hypertension, may explain part of these defects. In the present study we investigated whether microvascular function is impaired in essential hypertension and relates to insulin's metabolic and vasodilatatory actions. Methods: We measured 24-h ambulatory blood pressure, capillary recruitment after arterial occlusion, and skin blood flow responses to iontophoresis of acetylcholine and sodium nitroprusside in 18 subjects with untreated essential hypertension and in 18 control subjects. Whole body insulin sensitivity and leg insulin-mediated vasodilatation were assessed with the hyperinsulinaemic clamp technique and plethysmography. Results: Hypertensive, as compared to normotensive, subjects had a decreased insulin sensitivity (0.8±0.3 vs. 1.7±0.6 mg kg-1 min-1 per pmol l-1; P<0.001), capillary recruitment after arterial occlusion (21.5±5.8 vs. 45.9±10.4%; P<0.001), acetylcholine-mediated vasodilatation (331±84 vs. 688±192%; P<0.001), and insulin-mediated vasodilatation (median 29.3 vs. 47.2%; P<0.05). Correlation analyses with adjustment for sex, age, body mass index and waist-to-hip ratio showed significant relationships of capillary recruitment after arterial occlusion with blood pressure (r=-0.68; P<0.01), insulin sensitivity (r=+0.55; P<0.01) and insulin-mediated vasodilatation (r=+0.51; P<0.05), which extended from the normotensive to the hypertensive range. Conclusion: Skin microvascular function is associated with blood pressure and insulin's metabolic and vasodilatatory actions, both in normotensive and hypertensive subjects. These findings offer a potential mechanistic explanation of the links among insulin resistance, impaired insulin-mediated vasodilatation and hypertension. (C) 2001 Elsevier Science B.V.

KW - Blood flow

KW - Capillaries

KW - Endothelial function

KW - Hypertension

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U2 - 10.1016/S0008-6363(00)00198-X

DO - 10.1016/S0008-6363(00)00198-X

M3 - Article

VL - 49

SP - 161

EP - 168

JO - Cardiovascular Research

JF - Cardiovascular Research

SN - 0008-6363

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ER -