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Adiponectin, insulin resistance, and left ventricular structure in dipper and nondipper essential hypertensive patients.
Am J Hypertens. 2005 Jan; 18(1):30-5.AJ

Abstract

BACKGROUND

Adiponectin is an adipocyte-derived protein with insulin-sensitizing and antiatherogenic properties. Failure to decrease blood pressure (BP) normally during night in hypertensive patients has been independently associated with left ventricular hypertrophy.

METHODS

We examined the relationship between adiponectin levels, insulin sensitivity, and left ventricular structure in 40 newly diagnosed never-treated patients with essential hypertension, including 20 patients with a normal night-time pressure decrease (ie, dippers) and 20 patients with BP persistently elevated throughout the 24-h period (ie, nondippers). All subjects had grade 1-2 hypertension, aged 18 to 65 years, no diabetes mellitus, no obesity, no hyperlipidemia, and no cardiopulmonary, renal, or hepatic disease.

RESULTS

The two groups of patients were similar for age, sex, body mass index, and had no differences for clinic, 24-h, and diurnal BP, and 24-h, diurnal, and nocturnal heart rate, as well as glucose, total cholesterol, and triglyceride levels. Plasma insulin and homeostasis model assessment (HOMA index) were higher (P < .01), and adiponectin levels were lower (P < .005) in nondippers than in dippers. Adiponectin correlated inversely with HOMA index and insulin levels (r = -0.58, and r = -0.62, respectively, P < .001) in the entire population. Nondippers showed left ventricular mass, relative wall thickness, and measure of early and late diastolic peak flow velocity ratio similar to those of dippers.

CONCLUSIONS

In the absence of major cardiovascular risk factors, nondipper essential hypertensive patients show more prominent insulin resistance and lower adiponectin compared to dippers. Therapeutic modulation of adiponectin or insulin resistance might provide additional benefit to the conventional antihypertensive treatment.

Authors+Show Affiliations

Della Mea P
Department of Medical and Surgical Sciences, University of Padova, Padova, Italy.
Lupia M
No affiliation info available
Bandolin V
No affiliation info available
Guzzon S
No affiliation info available
Sonino N
No affiliation info available
Vettor R
No affiliation info available
Fallo F
No affiliation info available

MeSH

AdiponectinAdolescentAdultAgedBlood PressureBlood Pressure Monitoring, AmbulatoryCircadian RhythmEchocardiographyFemaleHeart VentriclesHumansHypertensionInsulin ResistanceMaleMiddle AgedProspective StudiesVentricular Function, LeftVentricular Remodeling

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15691614

Citation

Della Mea, Paolo, et al. "Adiponectin, Insulin Resistance, and Left Ventricular Structure in Dipper and Nondipper Essential Hypertensive Patients." American Journal of Hypertension, vol. 18, no. 1, 2005, pp. 30-5.
Della Mea P, Lupia M, Bandolin V, et al. Adiponectin, insulin resistance, and left ventricular structure in dipper and nondipper essential hypertensive patients. Am J Hypertens. 2005;18(1):30-5.
Della Mea, P., Lupia, M., Bandolin, V., Guzzon, S., Sonino, N., Vettor, R., & Fallo, F. (2005). Adiponectin, insulin resistance, and left ventricular structure in dipper and nondipper essential hypertensive patients. American Journal of Hypertension, 18(1), 30-5.
Della Mea P, et al. Adiponectin, Insulin Resistance, and Left Ventricular Structure in Dipper and Nondipper Essential Hypertensive Patients. Am J Hypertens. 2005;18(1):30-5. PubMed PMID: 15691614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adiponectin, insulin resistance, and left ventricular structure in dipper and nondipper essential hypertensive patients. AU - Della Mea,Paolo, AU - Lupia,Mario, AU - Bandolin,Valentina, AU - Guzzon,Samuele, AU - Sonino,Nicoletta, AU - Vettor,Roberto, AU - Fallo,Francesco, PY - 2004/05/12/received PY - 2004/07/20/revised PY - 2004/08/27/accepted PY - 2005/2/5/pubmed PY - 2006/6/6/medline PY - 2005/2/5/entrez SP - 30 EP - 5 JF - American journal of hypertension JO - Am J Hypertens VL - 18 IS - 1 N2 - BACKGROUND: Adiponectin is an adipocyte-derived protein with insulin-sensitizing and antiatherogenic properties. Failure to decrease blood pressure (BP) normally during night in hypertensive patients has been independently associated with left ventricular hypertrophy. METHODS: We examined the relationship between adiponectin levels, insulin sensitivity, and left ventricular structure in 40 newly diagnosed never-treated patients with essential hypertension, including 20 patients with a normal night-time pressure decrease (ie, dippers) and 20 patients with BP persistently elevated throughout the 24-h period (ie, nondippers). All subjects had grade 1-2 hypertension, aged 18 to 65 years, no diabetes mellitus, no obesity, no hyperlipidemia, and no cardiopulmonary, renal, or hepatic disease. RESULTS: The two groups of patients were similar for age, sex, body mass index, and had no differences for clinic, 24-h, and diurnal BP, and 24-h, diurnal, and nocturnal heart rate, as well as glucose, total cholesterol, and triglyceride levels. Plasma insulin and homeostasis model assessment (HOMA index) were higher (P < .01), and adiponectin levels were lower (P < .005) in nondippers than in dippers. Adiponectin correlated inversely with HOMA index and insulin levels (r = -0.58, and r = -0.62, respectively, P < .001) in the entire population. Nondippers showed left ventricular mass, relative wall thickness, and measure of early and late diastolic peak flow velocity ratio similar to those of dippers. CONCLUSIONS: In the absence of major cardiovascular risk factors, nondipper essential hypertensive patients show more prominent insulin resistance and lower adiponectin compared to dippers. Therapeutic modulation of adiponectin or insulin resistance might provide additional benefit to the conventional antihypertensive treatment. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/15691614/Adiponectin_insulin_resistance_and_left_ventricular_structure_in_dipper_and_nondipper_essential_hypertensive_patients_ DB - PRIME DP - Unbound Medicine ER -