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Q J Med 1994; 87: 431-436
© 1994 Association of Physicians

research-article

Insulin-mediated glucose disposal in black South Africans with essential hypertension

J.R. WING, M.T. VAN DER MERWE, B.I. JOFFE, V.R. PANZ and H.C. SEFTEL

Department of Medicine and Division of Endocrinology and Metabolism, University of the Witwatersrand Medical School Johannesburg, South Africa

Address correspondence to Dr.J.R. Wing, Department of Medicine, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa

Received 21 February 1994 Accepted for publication 14 July 1994.

We used the hyperinsulinaemic euglycaemic clamp method to assess insulin-mediated glucose disposal in ten black South African patients with newlydiagnosed essential hypertension, compared to ten normotensive controls. The patients were all nonobese with normal glucose tolerance. Comparisons were made before and 12 weeks after treatment with a long-acting ACE inhibitor. The mean glucose disposal (M) and disposal expressed as glucose sensitivity index (M/l) were significantly reduced in the hypertensives vs. controls (M: 6.8±0.9 vs. 9.7±0.8 mg/kg/min; M1: 7.1±1.0 vs. 12.5±1.7 mg/kg/min/mU/lx100) (p=0.03 and 0.01, respectively). Following therapy, M/l increased in the patients to values not significantly different to those of the controls. Insulin resistance is an independent feature of essential hypertension in black South African patients, and is partially corrected by treatment with a long-acting ACE inhibitor.


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