Fasting Serum Insulin Levels in Essential Hypertension

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Abstract
Background.— The role of insulin in the genesis of essential hypertension remains an area of intense controversy. Most clinical evidence suggests a definite association. Several pathophysiologic mechanisms have been proposed. However, current data remain disparate and contradictory. Methods.— Meta-analysis allows data pooling of primary study findings and subsequent integration into a statistically meaningful outcome. This method was used to study the relationship in euglycemic individuals between blood pressure and fasting serum insulin level, age, body mass index, and fasting plasma glucose level. Results.— A significant correlation was demonstrated between fasting serum insulin concentration and both systolic blood pressure and diastolic blood pressure. Age and body mass index also revealed meaningful associations. The meta-analytic correlation between plasma glucose level and both systolic blood pressure and diastolic blood pressure failed to achieve significance. Conclusions.— Data from a meta-analytic review examining fasting serum insulin levels in euglycemic individuals demonstrate a significant correlation with systolic and diastolic blood pressure. This study supports the role of hyperinsulinemia in the pathogenesis of essential hypertension. (Arch Intern Med. 1992;152:1649-1651)