Relationship between insulin resistance and artherosclerosis in senile hypertensive patients

Objective To investigate the characteristics of carotid and coronary artery artherosclerosis in senile hypertensive patients concomitant with diabetes,and evaluate the role of insulin resistance in the pathogenesis of this disease.Methods Sixty-four patients were enrolled into this study,and were divided into three groups:essential hypertensive group(EH,n=29) ,essential hypertension with diabetes group(EH+DM,n=21) ,and normotensive group(n=14) .All these subjects were underwent carotid Doppler ultrasonography and coronary artery computed tomography(CT) .The homeostasis model assessment insulin resistance index(HOMA-IR) was calculate based upon the levels of fast blood glucose(FBG) and insulin.The relationship between HOMA-IR and risks of cardiovascular diseases was also analyzed.Results ① HOMA-IR was closely related with body mass index(BMI) ,FBG and plaque score of carotid artery;② The intima-media thickness(IMT) ,bifurcate IMT and carotid arterial plaque score were higher in patients with hypertension than those in control group.Patients in EH+DM group demonstrated the highest levels of parameters mentioned-above among these three groups;③Coronary calcification score and the number of stenosed coronary artery were higher in hypertensive subjects with diabetes than those in hypertensive group.Conclusions In senile hypertensive patients concomitant with diabetes,the extent of artery artherosclerosis is worse compared with those with hypertension alone.Insulin resistance may play an important role in the pathogenesis of artherosclerosis.