Insulin resistance linked to future hypertension in normotensive salt-sensitive individuals

A 10-year study has found the association of salt sensitivity with insulin resistance and endothelial dysfunction in the offspring of hypertensive salt-sensitive parents, making them susceptible to developing hypertension.

The authors examined normotensive salt-sensitive (group 1; n=41, mean age 29 years) or salt-resistant offspring (group 2; n=36, mean age 25 years) of hypertensive patients in this 10-year follow-up study. Both groups were deemed lean.

An evaluation of baseline creatinine clearance (CrCl), 24-h urinary albumin excretion (UAE), glycaemia, and insulinaemia was done before and after 60 and 120 min of glucose overload (75 g).

The authors calculated the HOMA Index and the area under the curve (AUC), as well as blood pressure (BP) and UAE annually. They also examined postischaemic minimum vascular resistance (forearm plethysmography) at baseline.

Group 1 had higher UAE (53 vs 12 mg/min; p=0.01) and CrCl (136 vs 107 ml/min; p<0.01) than group 2. In addition, participants in group 1 showed an impaired vasodilatory postischaemic response relative to those in group 2 (p<0.01). Glycaemia, insulin, AUC at 69 and 120 min after glucose test were also higher in the former (p<0.02).

At 10-year follow-up, individuals in group 1 had increased BP (p<0.01) relative to those in group 2.

“Salt sensitivity in the offspring of hypertensive salt-sensitive individuals is associated with insulin resistance and endothelial dysfunction and is prone to hypertension over a short period of time,” the authors said.