Longitudinal Changes in the Blood Pressure Responses to, and Gastric Emptying of, an Oral Glucose Load in Healthy Older Subjects

Background: The vasodilator action of insulin might contribute to the reduction of blood pressure in the postprandial state and it remains to be clarified whether this action is impaired in the insulin- resistant obese state or not. Aims and Objective: The present study aimed to determine the blood pressure responses after an oral glucose load in lean and insulin resistant centrally obese adult male subjects. Materials and Methods: This study was carried out in eleven lean and eleven centrally obese adult male subjects. After a 75 g oral glucose load, blood pressures were measured at 15-minute intervals and the serum insulin level was determined at 30-minute intervals for two hours. Blood pressure was measured by indirect sphygmomanometry and serum insulin concentration was analyzed by ELISA method. Results: All centrally obese subjects were insulin resistant (HOMA-IR≥2.6). After oral glucose load, the per cent change in glucose-stimulated insulin responses at 30 minutes (626% vs 344%, p<0.05) and at 60 minutes (756% vs 417%, p<0.01) were significantly greater in the lean group than the centrally obese group. The fall in postprandial blood pressures started at 15 minutes and returned to baseline values at 120 minutes. The per cent change in SBP at 15 minutes (-2.2% vs -1.2%, p<0.05) and at 30 minutes (-3.2% vs -2.1%, p<0.05) were significantly greater in the lean group than the centrally obese group. Conclusion: The present findings suggest that attenuation in BP responses as well as a lesser change in glucose-stimulated insulin responses in the centrally obese subjects might be attributable to the presence of insulin resistance.

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Insulinemia and Blood Pressure Responses to Oral Glucose Load in Primary Hypertensive Patients

Cardiology ◽

10.1159/000174852 ◽

1991 ◽

Vol 79 (1) ◽

pp. 14-19 ◽

Cited By ~ 2

Author(s):

Elza Olga Ana Muscelli ◽

Mario José Abdalla Saad ◽

José Antonio Rocha Gontijo

Keyword(s):

Blood Pressure ◽

Oral Glucose ◽

Oral Glucose Load ◽

Glucose Load ◽

Hypertensive Patients ◽

Blood Pressure Responses

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Impact of gastric emptying to the glycemic and insulinemic responses to a 75-g oral glucose load in older subjects with normal and impaired glucose tolerance

Physiological Reports ◽

10.14814/phy2.12204 ◽

2014 ◽

Vol 2 (11) ◽

pp. e12204 ◽

Cited By ~ 13

Author(s):

Laurence G. Trahair ◽

Michael Horowitz ◽

Chinmay S. Marathe ◽

Kylie Lange ◽

Scott Standfield ◽

...

Keyword(s):

Gastric Emptying ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Oral Glucose ◽

Oral Glucose Load ◽

Glucose Load ◽

Older Subjects

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Effects of drink volume and glucose load on gastric emptying and postprandial blood pressure in healthy older subjects

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00030.2005 ◽

2005 ◽

Vol 289 (2) ◽

pp. G240-G248 ◽

Cited By ~ 33

Author(s):

Karen L. Jones ◽

Deirdre O’Donovan ◽

Antonietta Russo ◽

James H. Meyer ◽

Julie E. Stevens ◽

...

Keyword(s):

Blood Pressure ◽

Blood Glucose ◽

Gastric Emptying ◽

Glucose Concentration ◽

The Elderly ◽

Gastric Distension ◽

Oral Glucose ◽

Glucose Content ◽

Older Subjects ◽

Hypotensive Response

Postprandial hypotension (PPH) occurs frequently in the elderly; the magnitude of the fall in blood pressure (BP) is related to the rate of glucose entry into the duodenum during intraduodenal glucose infusion and spontaneous gastric emptying (GE). It is unclear if glucose concentration affects the hypotensive response. Gastric distension may attenuate PPH; therefore, meal volume could influence the BP response. We aimed to determine the effects of 1) drink volume, 2) glucose concentration, and 3) glucose content on the BP and heart rate (HR) responses to oral glucose. Ten subjects (73.9 ± 1.2 yr) had measurements of BP, GE, and blood glucose on 4 days after 1) 25 g glucose in 200 ml (12.5%), 2) 75 g glucose in 200 ml (37.5%), 3) 25 g glucose in 600 ml (4%), and 4) 75 g glucose in 600 ml (12.5%). GE, BP, HR, and blood glucose were measured for 180 min. After all drinks, duodenal glucose loads were similar in the first 60 min. Regardless of concentration, 600-ml (but not 200-ml) drinks initially increased BP, and in the first 30 min, systolic BP correlated ( P < 0.01) with volume in both the proximal and total stomach. At the same concentration (12.5%), systolic BP fell more ( P = 0.02) at the smaller volume; at the same volumes, there were no effects of concentration on BP. There was no difference in the glycemic response to drinks of identical glucose content. We conclude that 1) ingestion of glucose at a higher volume attenuates and 2) under constant duodenal load, glucose concentration (4–37%) does not affect the fall in BP.

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Metoprolol in Diabetes Mellitus: Effect on Glucose Homeostasis

Clinical Science ◽

10.1042/cs059469s ◽

1980 ◽

Vol 59 (s6) ◽

pp. 469s-472s ◽

Cited By ~ 7

Author(s):

B. N. Garrett ◽

P. Raskin ◽

N. M. Kaplan

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Plasma Renin Activity ◽

Glucose Homeostasis ◽

Plasma Glucose ◽

Plasma Renin ◽

Renin Activity ◽

Oral Glucose ◽

Oral Glucose Load ◽

Glucose Load

1. In eight hypertensive diabetic subjects receiving hydrochlorothiazide, glucose homeostasis as measured by the changes in plasma glucose, insulin and glucagon after an oral glucose load was not significantly affected by 8 weeks of therapy with metoprolol. 2. The combination of metoprolol plus hydrochlorothiazide significantly lowered blood pressure in all subjects. 3. Plasma renin activity was suppressed by therapy with metoprolol.

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Role of nitric oxide mechanisms in gastric emptying of, and the blood pressure and glycemic responses to, oral glucose in healthy older subjects

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00511.2004 ◽

2005 ◽

Vol 288 (6) ◽

pp. G1227-G1232 ◽

Cited By ~ 18

Author(s):

Diana Gentilcore ◽

Renuka Visvanathan ◽

Antonietta Russo ◽

Reawika Chaikomin ◽

Julie E. Stevens ◽

...

Keyword(s):

Nitric Oxide ◽

Blood Pressure ◽

Blood Glucose ◽

Gastric Emptying ◽

Plasma Insulin ◽

Oral Glucose ◽

Incretin Hormones ◽

Double Blind ◽

Older Subjects ◽

Synthase Inhibitor

The primary aims of this study were to evaluate the effects of the nitric oxide (NO) synthase inhibitor NG-nitro-l-arginine methyl ester (l-NAME) on gastric emptying (GE) of, and the blood pressure (BP), glycemic, insulin, and incretin responses to, oral glucose in older subjects. Eight healthy subjects (4 males and 4 females, aged 70.9 ± 1.3 yr) were studied on two separate days, in double-blind, randomized order. Subjects received an intravenous infusion of either l-NAME (180 μg·kg−1·h−1) or saline (0.9%) at a rate of 3 ml/min for 150 min. Thirty minutes after the commencement of the infusion (0 min), subjects consumed a 300-ml drink containing 50 g glucose labeled with 20 MBq 99mTc-sulfur colloid, while sitting in front of a gamma camera. GE, BP (systolic and diastolic), heart rate (HR), blood glucose, plasma insulin, and incretin hormones, glucose-dependant insulinotropic-polypeptide (GIP), and glucagon-like peptide-1 (GLP-1), were measured. l-NAME had no effect on GE, GIP, and GLP-1. Between −30 and 0 min l-NAME had no effect on BP or HR. After the drink (0–60 min), systolic and diastolic BP fell ( P < 0.05) and HR increased ( P < 0.01) during saline; these effects were attenuated ( P < 0.001) by l-NAME. Blood glucose levels between 90 and 150 min were higher ( P < 0.001) and plasma insulin were between 15 and 150 min less ( P < 0.001) after l-NAME. The fall in BP, increase in HR, and stimulation of insulin secretion by oral glucose in older subjects were mediated by NO mechanisms by an effect unrelated to GE or changes in incretin hormones.

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Taurine attenuates hypertension and improves insulin sensitivity in the fructose-fed rat, an animal model of insulin resistance

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y99-060 ◽

1999 ◽

Vol 77 (10) ◽

pp. 749-754 ◽

Cited By ~ 56

Author(s):

C V Anuradha ◽

S D Balakrishnan

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Renal Function ◽

Glucose Tolerance ◽

Plasma Levels ◽

Oral Glucose ◽

Oral Glucose Load ◽

Glucose Load ◽

Blood Pressure Elevation ◽

Glucose Levels

Fructose feeding induces moderate increases in blood pressure levels in normal rats, which is associated with hyperinsulinemia, insulin resistance, and impaired glucose tolerance. Increased vascular resistance, sodium retention, and sympathetic overactivity have been proposed to contribute to the blood pressure elevation in this model. Taurine, a sulphur-containing amino acid, has been reported to have antihypertensive and sympatholytic actions. In the present study, the effects of taurine on blood pressure, plasma levels of glucose and insulin, glucose tolerance, and renal function were studied in fructose-fed rats. Fructose-fed rats had higher blood pressure and elevated plasma levels of insulin and glucose. The plasma glucose levels were higher in fructose-fed rats than in controls at 15, 30, and 60 min after the oral glucose load. Treatment with 2% taurine in drinking water prevented the blood pressure elevation and attenuated the hyperinsulinemia in fructose-fed rats. The exaggerated glucose levels in response to the oral glucose load was also prevented by taurine administration. Thus, taurine supplementation could be beneficial in circumventing metabolic alterations in insulin resistance.Key words: fructose feeding, hypertension, hyperinsulinemia, renal function, taurine.

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Effect of solid meal on gastric emptying of, and glycemic and cardiovascular responses to, liquid glucose in older subjects

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00163.2002 ◽

2003 ◽

Vol 284 (4) ◽

pp. G655-G662 ◽

Cited By ~ 15

Author(s):

Melanie K. Berry ◽

Antonietta Russo ◽

Judith M. Wishart ◽

Anne Tonkin ◽

Michael Horowitz ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Blood Glucose ◽

Gastric Emptying ◽

Serum Insulin ◽

Cardiovascular Responses ◽

Oral Glucose ◽

Mixed Meal ◽

Solid Meal ◽

Older Subjects

Gastric emptying is a determinant of the postprandial glycemic and cardiovascular responses to oral carbohydrate. We evaluated the effects of a solid meal on gastric emptying and the glycemic and cardiovascular responses to oral glucose in healthy older subjects. Ten subjects aged 72.1 ± 1.9 yr were studied. Each subject had measurements of gastric emptying, blood glucose, serum insulin, blood pressure, and heart rate after ingestion of a 50-g glucose drink (300 ml) with (mixed meal) or without (liquid only) a solid meal (300 g ground beef). Gastric emptying of liquid was initially slightly more rapid ( P < 0.05) after the mixed meal compared with liquid only at 5 min (92.0 ± 1.5 vs. 96.0 ± 1.3%) and much slower ( P < 0.05) after 120 min. The time to peak blood glucose was less (39.0 ± 4.0 vs. 67.5 ± 10.3 min; P < 0.01) and blood glucose subsequently lower ( P < 0.01) after the mixed meal. The increase in serum insulin was greater ( P < 0.001) after the mixed meal. Blood pressure fell ( P < 0.05) in the first 30 min, with no difference between the two meals. Increase in heart rate after both meals ( P < 0.005), was greater ( P< 0.05) after the mixed meal. The presence of a noncarbohydrate solid meal had discrepant effects on early and subsequent emptying of a nutrient liquid, which affects postprandial glycemia and increased heart rate.

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