Effect of Insulin Resistance on Vascular Remodeling in Comorbidity of Arterial Hypertension and Obesity

Abstract

The objective: to evaluate the effect of insulin resistance on vascular remodeling in patients with comorbidity of arterial hypertension and obesity.Materials and methods. We examined 200 patients with hypertension and obesity class I-II. The patients were divided into two groups depending on the presence of insulin resistance: the first group included 80 patients without insulin resistance, and the second – 120 patients with insulin resistance.Results. in comorbidity of hypertension and obesity the presence of insulin resistance affects the severity of vascular remodeling. In the presence of insulin resistance, hypertensive patients with concomitant obesity have significantly higher intima-media thickness of the carotid artery at the level of bifurcation, the pulse wave velocity in the carotid artery and abdominal aorta, as compared to patients without insulin resistance. In patients with comorbidity of hypertension and obesity, HOMA-IR directly correlates with such parameters of vascular remodeling as the intima-media thickness (including at the level of bifurcation), the pulse wave velocity in the carotid artery and the abdominal aorta. In hypertensive patients with obesity in the absence of insulin resistance, an increase in HOMAIR is associated with an increase in the pulse wave velocity of the carotid artery, and in patients with insulin resistance – with an increase in the intima-media thickness of the carotid artery.Conclusion. In the future, it is necessary to assess the effect of IR on the hemodynamic and metabolic parameters of patients with hypertension and concomitant obesity.