Sikandar Hayat Khan, Farooq Ahmad Khan, Amir Ijaz, Abdus Sattar, Mohammad Dilawar, Rizwan Hashim.
Hypertension and metabolic syndrome: Impact of clustering of hypertension in subjects with metabolic syndrome
Pak J Med Sci Oct - Dec 2007;23(5):903-8.
Armed Forces Institute of Pathology, Rawalpindi

Objective: To compare insulin resistance between hypertensive and non-hypertensive subjects. Methodology: It is a comparative cross-sectional study which was carried out between April 2004 to March 2006 at department of chemical pathology and endocrinology, Armed Forces Institute of Pathology, Rawalpindi. A total of sixty-three subjects with metabolic syndrome were selected as per the criteria of National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) from a target population diagnosed to have impaired glucose regulation at AFIP, along with forty-seven age and sex-matched controls. Insulin resistance was calculated by the method of HOMA-IR, using the formula of Mathew`s et al. Blood pressure was measured as per recommendations of JNC7 report on prevention, detection, evaluation and treatment of high blood pressure. Results: The difference for hypertension for diastolic blood pressure between subjects with and without metabolic syndrome were found to be significant [Metabolic syndrome: 86.79 mm of Hg (95 % CI: 83.75-89.84), Age and sex matched controls: 80.21(95 % CI: 76.80-83.62) (p<0.05). However the difference for systolic blood pressure were not found to be significant between the two groups (p=0.860).Hypertensive individuals had higher HOMA-IR [(n=33): 2.87 (95 % CI: 2.37-3.05)] than non-hypertensive [(n=30): 1.76(95 % CI: 1.53-2.05)] (p<0.05).The effect of obesity as determined by waist circumference between patients with and without hypertension remained significant (p=< 0.05) Conclusion: Hypertensive individuals have higher insulin resistance than subjects without hypertension. Thus it is recommended that vigorous search be made to diagnose insulin resistance in subjects diagnosed to have hypertension, and to demonstrate other components of metabolic syndrome.

Category: Internal Medicine
Keywords: Homeostasis Model Assessment. Insulin Resistance. Hypertension. Metabolic Syndrome. Cholesterol. Lipids.

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