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Depressor action of insulin on skeletal muscle vasculature: a novel mechanism for postprandial hypotension in the elderly.
J Am Coll Cardiol. 1998 Jan; 31(1):209-16.JACC

Abstract

OBJECTIVES

We sought to assess the role of insulin in postprandial blood pressure regulation in the elderly.

BACKGROUND

Insulin is both a positive inotropic and chronotropic hormone that also vasodilates skeletal muscle vasculature. Insulin may thus mediate aspects of postprandial cardiovascular homeostasis.

METHODS

Ten healthy elderly subjects were studied in the fasting state on three separate days. After baseline supine hemodynamic and neurohumoral measurements were taken (cardiac output and superior mesenteric artery blood flow were measured using Doppler ultrasound, and calf blood flow was measured using venous occlusion plethysmography), subjects ate on one occasion a 2.5-MJ high carbohydrate meal and on the other two occasions, an isoenergetic high fat meal. One high fat meal was accompanied by an insulin infusion reproducing the plasma insulin profile seen after a high carbohydrate meal while maintaining the glycemic profile seen after a high fat meal alone. After meal ingestion, measurements were repeated every 20 min for 2 h.

RESULTS

After the three meals, there were similar increments in cardiac output and heart rate. After the high carbohydrate meal and high fat meal with insulin, mean arterial blood pressure fell by between 8 to 10 mm Hg, but did not change after the high fat meal. After the high carbohydrate meal and the high fat meal with insulin, calf vascular resistance did not change, whereas after the high fat meal, it increased by 15.5 +/- 4.4 U (mean +/- SEM).

CONCLUSIONS

Insulin contributes to the failure of calf vasoconstriction seen after a high carbohydrate meal. By this vasodepressor action, insulin is at least in part responsible for the fall in blood pressure after a high carbohydrate meal.

Authors+Show Affiliations

Department of Physiology and Pharmacology, University Medical School, Queens Medical Centre, Nottingham, England, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9426042

Citation

Kearney, M T., et al. "Depressor Action of Insulin On Skeletal Muscle Vasculature: a Novel Mechanism for Postprandial Hypotension in the Elderly." Journal of the American College of Cardiology, vol. 31, no. 1, 1998, pp. 209-16.
Kearney MT, Cowley AJ, Stubbs TA, et al. Depressor action of insulin on skeletal muscle vasculature: a novel mechanism for postprandial hypotension in the elderly. J Am Coll Cardiol. 1998;31(1):209-16.
Kearney, M. T., Cowley, A. J., Stubbs, T. A., Evans, A., & Macdonald, I. A. (1998). Depressor action of insulin on skeletal muscle vasculature: a novel mechanism for postprandial hypotension in the elderly. Journal of the American College of Cardiology, 31(1), 209-16.
Kearney MT, et al. Depressor Action of Insulin On Skeletal Muscle Vasculature: a Novel Mechanism for Postprandial Hypotension in the Elderly. J Am Coll Cardiol. 1998;31(1):209-16. PubMed PMID: 9426042.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depressor action of insulin on skeletal muscle vasculature: a novel mechanism for postprandial hypotension in the elderly. AU - Kearney,M T, AU - Cowley,A J, AU - Stubbs,T A, AU - Evans,A, AU - Macdonald,I A, PY - 1998/1/13/pubmed PY - 1998/1/13/medline PY - 1998/1/13/entrez SP - 209 EP - 16 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 31 IS - 1 N2 - OBJECTIVES: We sought to assess the role of insulin in postprandial blood pressure regulation in the elderly. BACKGROUND: Insulin is both a positive inotropic and chronotropic hormone that also vasodilates skeletal muscle vasculature. Insulin may thus mediate aspects of postprandial cardiovascular homeostasis. METHODS: Ten healthy elderly subjects were studied in the fasting state on three separate days. After baseline supine hemodynamic and neurohumoral measurements were taken (cardiac output and superior mesenteric artery blood flow were measured using Doppler ultrasound, and calf blood flow was measured using venous occlusion plethysmography), subjects ate on one occasion a 2.5-MJ high carbohydrate meal and on the other two occasions, an isoenergetic high fat meal. One high fat meal was accompanied by an insulin infusion reproducing the plasma insulin profile seen after a high carbohydrate meal while maintaining the glycemic profile seen after a high fat meal alone. After meal ingestion, measurements were repeated every 20 min for 2 h. RESULTS: After the three meals, there were similar increments in cardiac output and heart rate. After the high carbohydrate meal and high fat meal with insulin, mean arterial blood pressure fell by between 8 to 10 mm Hg, but did not change after the high fat meal. After the high carbohydrate meal and the high fat meal with insulin, calf vascular resistance did not change, whereas after the high fat meal, it increased by 15.5 +/- 4.4 U (mean +/- SEM). CONCLUSIONS: Insulin contributes to the failure of calf vasoconstriction seen after a high carbohydrate meal. By this vasodepressor action, insulin is at least in part responsible for the fall in blood pressure after a high carbohydrate meal. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/9426042/Depressor_action_of_insulin_on_skeletal_muscle_vasculature:_a_novel_mechanism_for_postprandial_hypotension_in_the_elderly_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(97)00451-8 DB - PRIME DP - Unbound Medicine ER -