arterial hypertension, resistance, hemodynamics, hormonal and vegetative factors


The combination of arterial hypertension (AH) and insulin resistance (IR) significantly increases the risk of cardiovascular complications. Research objective: Studying indices of carbohydrate metabolism, activity of renin-angiotensin-aldosterone system, calcium-regulating hormones, adrenal glucocorticoid function, the condition of the autonomic nervous system and their possible interrelation with hemodynamic parameters in AH patients with different insulin sensitivity. A comprehensive study of hormonal profile was held with use of radio immune method and that of central hemodynamics with use of echocardiography in 72 patients with arterial hypertension stage II, 1-2 degrees, male (mean age – 54.1±3.4 years), with a body mass index up to 30 kg / mІ and verified insulin resistance (IR), in 32 patients of which insulin resistance (IR) was revealed, and in 40 patients its absence was fixed. Insulin resistance was verified by the value of HOMA-IR in excess of 2,77. To assess the condition of the autonomic nervous system, studies of heart rate variability were performed. It is established that patients with hypertension with IR had increased level of plasma renin activity, levels of angiotensin II, cortisol, insulin, parathyroid hormone, decreased parasympathetic and increased sympathetic tonus. According to the results of factor analysis, AH with insulin resistance has a distinctive structure of neurohumoral regulation of the main indicators of central hemodynamics and interhormonal interactions; the direct regulatory effects of angiotensin II, insulin, progesterone, parathyroid hormone on the indicators of central hemodynamics, modulation of presorption action increases. The study not only revealed peculiarities of neurohumoral profiles in patients with hypertension depending on insulin resistance, but also determined distinctive features in structure of the regulatory process of central hemodynamics and interhormonal interactions. This should be taken into account when prescribing antihypertensive therapy.


Ormazabal V, Nair S, Elfeky O, et al. Cardiovascular Diabetol 2 018; 1 7(1): 1 22-136. h ttps://doi.org/10.1186/s12933-018-0762-4.

Zhou D, Xi B, Zhao M, et al. Sci Rep 2018;8(1): 9418. https://doi.org/10.1038/s41598-018-27377-2.

Sokolova LA, Ievskaia EV, Vavilova TV, et al. Arterial Hypertens 2017; 23(4): 294-302. https://doi.org/10.18705/1607-419X-2017-23-4-294-302.

Pashentseva AV, Verbovoy AF, Sharonova LA. Obes Metab 2017; 14(2): 9-17. https://doi.org/10.14341/omet201729-17.

An Update Gutiйrrez-Rodelo C, Roura-Guiberna A, Olivares-Reyes JA. Gac Med Mex 2017; 153(2): 214-228.

Gao P, Hu Y, Wang J, et al. Med Sci Monit 2020; 26: e924334. https://doi.org/10.12659/MSM.924334.

Hшjlund K. Dan Med J 2014; 61(7): B4890.

Zhou M, Schulman I, ZengQ. Vasc Med 2012; 17(5): 330-341. https://doi.org/10.1177/1358863X12450094.

Williams B, Mancia G, Spiering W, et al. Eur Heart J 2018; 39(33): 3021-3104. https://doi.org/10.1093/eurheartj/ehy339.

Mancusi С, Izzo R, Giuseppe di Gioia, et al. High Blood Press Cardiovasc Prev 2020; 27(6): 515-526. https://doi.org/10.1007/s40292-020-00408-8.

Zhang S, Wei M, Yue M, et al. Endocrine 2018; 62(3): 588–601. https://doi.org/10.1007/s12020-018-1700-7.

Statsenko ME, Derevyanchenko MV. Rus J Cardiol 2020; 25(4): 27-34. https://doi.org/10.15829/1560-4071-2020-3752.

Seravalle G, Grassi G. High Blood Press Cardiovasc Prev 2016; 23: 175-179. https://doi.org/10.1007/s40292-016-0137-4.

Butakova SS, Nozdrachev AD. Advances in gerontol 2010; 23(3): 364-370.

Moisa S. J Biomed Sci Engineering 2 017; 10(7): 343-354. https://doi.org/10.4236/jbise.2017.107026.

Balu D, Ouyang J, Parakhia RA, et al. Biochem Biophys Rep 2 016; 5 : 3 65-373. h ttps://doi.org/10.1016/j.bbrep. 2016.01.007.

Kraemer WJ , Ratamess NA, Hymer WC, et al . Front Endocrinol (Lausanne) 2020; 25: 11-33. https://doi.org/10.3389/fendo.2020.00033.

Trehan N. Crit Pathw Cardiol 2 017; 1 6(3): 1 09-118. https://doi.org/10.1186/s40885-018-0094-4.

Horr S, Nissen S. Clin Endocrinol Metab 2016; 30(3): P.445-454. https://doi.org/10.1016/j.beem.2016.06.001.

Forrester SJ, Booz GW, Sigmund CD, еt al. Physiol Rev 2018; 98(3): 1627-1738. https://doi.org/10.1152/physrev. 00038.




How to Cite

Shevchuk, S., & Корчинський, В. (2021). HORMONAL AND VEGETATIVE FACTORS OF INSULIN RESISTANCE IN PATIENTS WITH HYPERTENSION. Problems of Endocrine Pathology, 77(3), 91-98. https://doi.org/10.21856/j-PEP.2021.3.13