TABLE 2.
Insulin resistance and hypertension in Asia
| Country | Method of assessment | Number of participants | Aims | Results | Conclusion |
|---|---|---|---|---|---|
| Egypt 21 | Fasting Insulin, BMI, WC, dyslipidemia | 60 euglycemic (30 patients with hypertension, 30 healthy controls) | Explore the pathogenic role of hyperinsulinemia in essential hypertension | Significant increase of fasting insulin level, BMI, WC, dyslipidemia than those in the control, highly significant increase of insulin with HTN severity | A possible pathogenic role of hyperinsulinemia on the onset of hypertension |
| Thailand 12 | HOMA‐IR | 227 men and 990 women | Estimate the prevalence of IR and related CVD risks | 25.1% men, 21.5% women have IR. | IR positively associated with selected CVD risk factors in Thai adults |
| Japan 13 | IFG, HOMA‐IR | 19 166 participants with different stages of impaired glucose metabolism | The relationship of IR and hypertension | The rate of HTN increase from 36.3% in normal glucose, to 50.1%, 50.8%, 58.3%, and 63/8% in isolated IFG, isolated impaired glucose tolerance, IFG and impaired glucose tolerance, & DM, respectively | Hyperglycemia and hyperinsulinemia are significant contributors to the presence of hypertension |
| Japan KEIO Study 14 | HOMA‐IR | 310 subjects, 30‐58 years divided in 3 groups according HOMA‐IR | Study the prediction the IR of hypertension (from 1993 to 2000) | Hypertension found in 11.7%, 15.4%, and 29.1% (highest HOMA‐IR), BP correlated with HOMA | Important role of IR in predicting HTN in middle‐aged Japanese men. |
| Japan 15 | HOMA‐IR, ABPM, ANP, BNP, LVH | 103 patients with hypertension divided in 2 groups: dipper and nondipper | Study the relation of IR with etiology of nondipper HTN | Fasting glucose, insulin and HOMA index were higher in nondippers | Diminished nocturnal BP fall closely related to LVH, BNP and IR may play a key role in these process |
| Japan 16 | IRI (M‐value), HIEC | 1996 subjects (475 men, 521 women in T; 469 men, 531 women in S), aged 40‐64 | Reveal the state of IR in Japanese HTN | IR was 45.4% in essential HTN and 16.3% in normotensive HTN | IR exist among Japanese essential HTN |
| Taiwan 17 | HOMA‐IR | 893 patients with hypertension, 889 control (Stanford Asian Pacific Program in HTN & IR sibling study) | Clustering and heritability of IR in Chinese & Japanese hypertensive families | IR is familial in nature & heritable in Chinese& Japanese HTN families | |
| Bangladesh 18 | HOMA‐IR | 150 male subjects, 75 male patients with hypertension | To observe the IR in adult males with HTN | Essential positive and significant relationship with IR | IR is higher in essential HTN |
| Vietnam 19 , 20 | Insulin dosage, glucose before & after OGTT | 108 patients with hypertension and 36 control persons, age > 40 years | To observe the IR in Vietnamese adults with HTN | Plasma insulin at fasting and 2 hours after OGTT were high in the patients with hypertension | There was a state of IR in hypertensive pts despite under nutrition |
Abbreviations: ABPM, 24 hour ambulatory blood pressure monitoring; ANP, atrial natriuretic peptid; BMI, body mass index; BNP, brain natriuretic peptid; HIEC, hyperinsulinnemic euglycemic clamp; HOMA‐IR, homeostasis model assessement – insulin resistance; HTN, hypertension; IFG, impaired fasting glucose; IR, insulin resistance; LVH, left ventricular hypertrophy; OGTT, oral glucose tolerance test; WC, waist circumference.