Abstract
In 1992 - 1995 in collaboration of the Clinic for Children and Youth in Prague 10 and the Endrocrinological Institute in Prague 1 a total of 75 juvenile hypertonic patients and 71 nonnotonic subjects aged 14-20 years were examined in order to test the validity of the hypothesis on the dominating effect of insulin resistance in the development of hypertension and cardiovascular disease in adult age. The following parameters were assessed: blood sugar level, insulinaemia, C-pepiide (as part of the oGTT), glucagon, catecholamines and their metabolites and lipids.
With the exception of the lipid profile and non-stimulated blood sugar and insulin levels the values of the mentioned markers were significantly higher in hypertonic than in normotonic subjects (p < 0.05 to 0.001). The same character of metabolic and humoral changes was found also in 14 non-obese hypertonics with hyperinsulinism.
The insulin resistance appears to be also in the development stage of juvenile hypertension a factor which is independent on obesity and impaired glucose tolerance. The mentioned trend of higher values was recorded also in the sub-group of normotonics - offspring of parents with cardiovascular risk, as compared with nonnotonic offspring of healthy parents.
The submitted results support the recommendation of active screening of subjects at risk and early initiation of therapeutic or preventive provisions. Their implementation calls for collaboration of paediatricians and general practitioners in the field.