Issue 129 Item 10 Adolescent Hypertension Associated With Insulin Resistance

Hypertension in adolescence may be an early manifestation of insulin resistance syndrome. Czech researchers report. In addition, they found that folate-homocysteine disturbances may play a role in its development.

Dr. Viktor Kozich from Charles University, Prague, and colleagues measured the levels of insulin, lipids, homocysteine and folate in 164 adolescents with essential hypertension, median 19 years of age, and in 173 normotensive controls.

Compared with controls, hypertensive subjects had higher body mass index and levels of insulin and lower HDL cholesterol.

They also had lower levels of folate and higher levels of homocysteine, the researchers found. Homocysteine levels were positively correlated with systolic blood pressure, while folate levels were inversely correlated with systolic blood pressure, they note.

Regression analysis revealed that risk for hypertension among these adolescents was significantly associated with fasting homocysteine, vitamin B12 and LDL cholesterol, according to the report in the October issue of the American Journal of Hypertension.

Dr. Kozich and colleagues conclude that "our study showed that the early stages of essential hypertension are associated with signs of insulin resistance syndrome, and with decreased plasma folate and increased total homocysteine concentrations."

They add that "novel treatment approaches may include modulation of insulin resistance through exercise or angiotensin converting enzyme inhibitors, and the correction of folate deficiency using dietary measures or low-dose oral folic acid treatment." Am J Hypertens 2002;15:857-864.