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Effect of insulin on heart function in horses with EMS

Last changed: 05 September 2019

There is little evidence that horses with equine metabolic syndrome (EMS) have higher resting blood pressures than horses with normal insulin sensitivity. However, there are indications that EMS horses have an altered dynamic response to the cardiovascular effects of insulin. The objective of the current study was to examine heart rate and the systemic blood pressure response in EMS and control horses during insulin infusion.

Study design

Cross‐sectional study.


Horses were examined with an oral sugar test (OST) and a euglycaemic hyperinsulinaemic clamp (EHC). Based on the results from the OST, the horses were classified as either EMS or control. Blood pressure was measured before the start of the EHC and at 60, 120 and 180 min of the EHC.


There were 16 EMS and 12 control horses. Mean resting heart rate was higher for EMS horses compared with control (35.6 ± 5.1 vs. 30.3 ± 3.5 beats/min). Systolic, diastolic and mean arterial blood pressure did not differ between groups at the start of the EHC. Blood pressure decreased gradually during the EHC in the control group, whereas the EMS group showed no decline in systolic, diastolic or mean arterial pressure.

Main limitations

Limited number of horses.


Horses with EMS have cardiovascular changes that affect resting heart rate and systemic blood pressure during insulin infusion.

Link to the publication


Nostell K, Lindåse S, Edberg H, Bröjer J. The effect of insulin infusion on heart rate and systemic blood pressure in horses with equine metabolic syndrome. Equine Vet J. 2019 Mar 18. doi: 10.1111/evj.13110. Epub ahead of print


Katarina Nostell
Senior Lecturer at the Department of Clinical Sciences; Equine Medicine Unit

Telephone: 018-671356