Neurovascular and hemodynamic responses to hyperinsulinemia in healthy postmenopausal women

Abstract

Acute hyperinsulinemia produces sympathetic activation, vasodilation, and cardiovascular changes in healthy young men. Postmenopausal period is accompanied by sympathetic, vascular and cardiovascular changes. Nevertheless, the effects of acute insulin infusion were not known in postmenopausal women. To study this aspect, 26 postmenopausal healthy women were submitted to an euglycemic hyperinsulinemic clamp performed during 120 min. Heart rate (HR: ECG), blood pressure (BP: oscillometric method), forearm blood flow (FBF: plethysmography), plasma norepinephrine (NE), plasma epinephrine (EP), and cardiovascular autonomic modulation (spectral analysis of R–R interval and BP variabilities) were measured before and during the clamp. Glycemia was kept similar to baseline during the clamp (84.6 ± 1.2 mg/dl versus 87.1 ± 1.6 mg/dl), while plasma insulin increased significantly to a level of 89.3 ± 5.6 μU/ml. Insulin infusion significantly increased plasma NE (+45 ± 17 pg/ml), EP (+20 ± 9 pg/ml), and low to high frequency ratio of R–R interval variability (LH/HF: 1.2 ± 0.4), but did not change low frequency component of BP variability. FBF (+0.7 ± 0.2 ml min −1 100 ml −1) was also significantly enhanced by hyperinsulinemia. HR and systolic BP increased with insulin infusion (+4 ± 1 bat/min and +6 ± 2 mmHg, respectively, P < 0.05), while diastolic BP did not change. In conclusion, in healthy postmenopausal women, acute hyperinsulinemia produces sympathetic activation, and vasodilation, which results in HR and systolic BP enhancements, with no change in diastolic BP. This pattern of response is similar to the one usually observed in healthy young men.