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Abstract
Introduction: Insulin resistance has been implicated in the pathogenesis of essential hypertension. Elevated blood pressure during physical exercise is a more powerful predictor of future hypertension than resting blood pressure. We have therefore studied the relationship between insulin resistance and blood pressure response to exercise in strongly hypertension‐prone subjects. Material: Twenty‐five normotensive subjects aged 18–35 years with bi‐parental hypertension, and 26 matched controls with normotensive parents. Methods: (i) Maximal exercise tolerance test with continuous gas‐exchange measurement; (ii) blood pressure at rest, during exercise and 24‐h ambulatory; (iii) euglycemic hyperinsulinemic clamp. Results: Diastolic blood pressure during exercise was higher in hypertension‐prone subjects as compared to controls, but only in subjects with low insulin sensitivity. Resting and 24‐h diastolic blood pressure were higher in hypertension‐prone subjects, but independent of insulin sensitivity level. Insulin sensitivity and exercise capacity were similar in the groups. Conclusion: Diastolic blood pressure during exercise was higher in hypertension‐prone subjects as compared to controls, but only in insulin‐resistant subjects. Since elevated blood pressure during physical exertion is a predictor of future hypertension, these findings may suggest that insulin resistance is involved in the pathogenesis of essential hypertension.