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Abstract

All 214 subjects with elevated blood pressure (BP)(≥140/≥90 mmHg) were selected from the total pool of overweight or obese individuals who completed one year of treatment consisting of diet + placebo (P) or diet + orlistat (O). Compared to subjects with normal fasting insulin levels (<90 pm/L), hypertensive subjects with high fasting insulin levels (≥90 pm/L) had significantly higher (p<0.05) initial values for body weight, fasting glucose, LDL-cholesterol (LDL-C), LDL/HDL-C, triglycerides and systolic BP plus lower levels of HDL-C.

After 1 year, no significant differences were observed between O and P in normal insulin subjects for changes in blood pressure, glucose, insulin or lipids despite greater weight loss with O vs P (-10.3±1.0% vs -6.4 ± 0.9%, p=0.0028). In high insulin subjects, the following changes were significantly greater for O than P: body weight (-9.3 ± 0.7% vs -5.2 ± 0.6%, p=0.0001), systolic BP (-17.6 ± 1.7 vs -12.6 ± 1.8 mmHg, p=0.035), diastolic BP (-10.6 ± 1.1 vs -8.5 ± 1.2 mmHg, p=0.022), insulin (-39 ± 5.8 vs -25 ± 7.5 pm/L, p=0.013), LDL-C (-0.49 ± 0.09 vs -0.18 ± 0.08 mm/L, p=0.035), or LDL/HDL-C (-0.44 ± 0.09 vs -0.09 ± 0.09, p=0.044).

In conclusion, CV risk factors are more likely to be abnormal in high insulin hypertension, and orlistat was more effective than placebo in improving these risk factors.

Insulin, Obesity, Cholesterol
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© American Journal of Hypertension, Ltd. 2001
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