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Multiple lines of evidence link high blood pressure and insulin resistance. However the influence of insulin resistance on hypertension in type 2 diabetics remains to be assessed to compare insulin resistance in hypertensive and normotensive patients with type 2 diabetes The study group concerned 41 patients recruited in an outpatient clinic. 23 patients with BP>130/85 mmHg were identified as mild hypertensive (20 from 23 under treatment). Insulin sensitivity was assessed with the use of the euglycemic insulin-clamp technique and biologic parameters such as lipids, PAI-1, insulin and proinsulin. An ambulatory blood pressure monitoring was performed in all patients. No significant difference was observed in age, body mass index, waist circumference, and insulin sensitivity. (See Table) hypertensivesnormotensivespAge53,91 ± 1,4352,33 ± 1,55NSBMI (kg/m2)30.57 ± 1,0328,69 ± 1,07NSwaist circumference106.22 ± 2,57101,82 ± 2,53NS24h SBP (mmHg)129,1 ± 2,96121,86 ± 2,80.09924h DBP (mmHg)80,56 ± 1,5576,64 ± 1,610.098Triglycerides (g/l)1,62 ± 0,141,63 ± 0,21NSPAI-1 (UI/ml)26,27 ± 1,9728,5 ± 2,4NSinsulin (mUI/l)25,62 ± 18.8322,63 ± 14,66NSproinsulin (pmol/l)29,62 ± 26,6132,69 ± 18,5NSClamp Rc (mg/kg/mn)5,43 ± 0,786,32 ± 0,5NS In this selected population of type 2 diabetics, insulin resistance was not significantly different between hypertensives and normotensives ; it is suggested that normotensive and mild hypertensive type 2 diabetics may present a similar degree of insulin resistance.

The aim of the study was to evaluate pulse wave velocity (PWV) and common carotid intima-media thickness (IMT) in type II diabetics with microalbuminuria (microalb). The study concerned 37 patients type II diabetics age: 53.4±6.6 years free of cardiovascular complications. HbA1C was 7.73±1.39 %, waist circonference 104.2±11.7 cm. 19 patients with BP > 130/85 mmHg were identified as mild hypertensives (17/19 under treatment). All patients underwent ABPM, PWV and IMT measurements. The study population was separated into 2 subgroups according to median of microalb (microg/24 h): 18.9. (See Table) PWV m/sIMT mmBP mmHgmicroalb <= 18.99.52 ± 0.30.58 ± 0.03123.5 ± 2/70.2 ± 1.4microalb >= 18.910.57 ± 0.40.66 ± 0.03131.7 ± 3/75.3 ± 2 In patients with microalb > 18.9, IMT* and PWV° were significantly increased (*p=0.06 ; °p <0.05). After adjustement to BP and age, there was no significant difference in IMT and PWV in the subgroups. In this selected population of type 2 diabetics microalbuminuria appears associated to a pressure-dependant vascular remodeling.