Hyperinsulinemic response to oral glucose in obese patients with essential hypertension

Background and objectives: Hypertension is a common health problem. The prevalence of hypertension increases progressively with increasing Body Mass Index. The aim of this study is to investigate changes in blood pressure (BP), plasma glucose (PG) and insulin level after ingestion of oral glucose; and to assess the relation between insulin level and BP in obese and non-obese normo-tensive and hypertensive subjects. Materials and Methods: Seventy five g glucose dissolved in 250 ml of water was given orally to 20 fasting newly diagnosed untreated patients with essential hypertension and 15 normo-tenisve control subjects matched for age, gender and Body Mass Index (BMI). Smokers and subjects with diabetes, hyperlipidemia, cardiac or renal disease or those taking medications were excluded. Subjects were monitored for 2 hours.Half hourly BP, PG and insulin were measured. Results: Subjects were classified into obese (BMI≥ 30 Kg/m2) (11 patients, 8 normo-tensives) and nonobese (BMI< 30 Kg/m2) (9 patients, 7 normo-tensives). In obese hypertensive patients, insulin showed significant positive correlation with: systolic BP (SBP) (P=.04), diastolic BP (DBP) (P=.04) and mean BP(MBP)(P=.03). Obese hypertensive patients showed a significantly higher insulin response to oral glucose than obese normo-tensive subjects (P=.02).In obese and non-obese hypertensive patients glucose intake was associated with significant drop in DBP((P≤ .005), (P< .05)) and MBP ((P< .005), (P< .05)) respectively.Conclusions: In obese hypertensive patients, the hyperinsulinemic response to oral glucose and the positive correlation of insulin with BP suggest that insulin may be involved in development of essential hypertension especially in obese patients

Variation of Asthma Symptoms Perception

Background: Asthmatic patients may perceive their symptoms inadequately putting them at a risk of a fatal attack because the severity of an exacerbation may be underestimated. The present study is intended to detect if disease duration affects the perception of asthma symptoms. The relation between asthma activity and evaluation methods commonly used in clinical practice; like presence of symptoms and asthma control test (ACT); was evaluated. Methods: The study involved 100 asthma patients with ages less than 40 years. Presence of symptoms; ACT score and spirometry were recorded to assess asthma activity at the time of examination. Cross tabulation of patients groups was used to screen for significant differences in the means using analysis of variance. Results: ACT score was higher while National Asthma Education and Prevention Program (NAEPP) class was lower in symptoms free compared with symptomatic asthmatic patients (P = 0.000 and 0.005 respectively). ACT score correlated negatively; while NAEPP correlated positively with age implying that asthma severity increases with age (CC = 0.41; P = 0.000 and CC = 0.28; P = 0.007). Asthma duration was significantly higher in well controlled compared with both poorly controlled and uncontrolled asthmatic patients (P = 0.000 for both). 5.7of asymptomatic patients were suffering from severe persistent asthma and 24.5from moderate persistent asthma according to NAEPP classification. Conclusion: Presence or absences of symptoms sometimes does not indicate asthma severity. Clinicians must therefore pay attention when comparing groups of asthma patients for whom severity categorization is largely based on symptomatology