Sympathetic nerve hyperactivity followed by hyperinsulinemia is related to the onset or progression of hypertension

To evaluate the relations among the onset of hypertension(HT), sympathetic nerve activity and hyperinsulinemia, we conducted this longitudinal study for 10yrs. Young, non-obese, age-and BMI-matched, Japanese 1064 normotensive(NT) and 283 borderline hypertensive(BHT) men were measured BMI, blood pressure(BP), fasting plasma insulin(INS) & norepinephrine(NOR) in supine position every year for 10yrs without any medications(At entry period: 42±3yrs,41±2, 22.8±1.2kg/m2,22.9±1.0, respectively). At year 10, 43(4%) NT(NE) and 93(33%) BHT(BE) developed to established HT(EHT), and 53(5%)NT(NB) developed to BHT without BMI increasing. As a positive family history of HT(FH+) was defined as at least one parent was HT, FH+ was recognized in 124(12%) of NT and 156(55%) of BHT, and all of NB, NE and BE had FH+. At entry period, supine NOR in NB, NE and BE were significantly greater than those in NN and BB, who remained in NT or BHT at year 10, but fasting INS were significantly greater only in BE than BB, not in NB nor NE compared to those in NN(BE>BB NE NB>NN, supine NOR;460>410 400 390>310pg/ml, INS;17>12>9=9 μU/ml). While, supine NOR and INS at year 10 were greater in BE NE NB BB>NN(NOR;420 400 380 370>290pg/ml, INS;18 17>14 12>8μU/ml). These results demonstrated that sympathetic nerve hyperactivity followed by hyperinsulinemia and positive family history of HT are the potent determinant factors on the onset or progression to HT.