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Hypertension and insulin resistance.

B N Prichard1, C C Smith, S Sen

  • 1Division of Clinical Pharmacology, University College London, England.

Journal of Cardiovascular Pharmacology
|January 1, 1992
PubMed
Summary

Insulin resistance and hyperinsulinemia are linked to various conditions, including hypertension. Lifestyle changes like weight loss and exercise can improve insulin sensitivity, while certain medications impact glucose metabolism.

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Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Syndrome

Background:

  • Insulin resistance and hyperinsulinemia are increasingly recognized in conditions such as type 2 diabetes, hypertension, obesity, and heart disease.
  • Several proposed mechanisms link hyperinsulinemia, insulin resistance, and hypertension, including altered sodium excretion and sympathetic nervous system activation.

Purpose of the Study:

  • To review the relationship between insulin resistance, hyperinsulinemia, and hypertension.
  • To discuss the impact of nonpharmacological and pharmacological interventions on these metabolic and cardiovascular parameters.

Main Methods:

  • Literature review of studies investigating insulin resistance, hyperinsulinemia, and hypertension.
  • Analysis of the effects of lifestyle modifications and various drug classes on insulin sensitivity and glucose metabolism.

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Main Results:

  • Nonpharmacological interventions like weight loss, exercise, and reduced salt intake benefit hyperinsulinemia and hypertension management.
  • Thiazide diuretics and beta-blockers can negatively affect insulin sensitivity and glucose tolerance, while ACE inhibitors and alpha-blockers appear neutral.
  • Evidence for hypertension treatment benefits on hard endpoints is currently limited to diuretics and beta-blockers.

Conclusions:

  • Lifestyle modifications are crucial for managing hyperinsulinemia and associated hypertension.
  • Pharmacological choices in hypertension management require careful consideration due to potential effects on insulin resistance and glucose metabolism.
  • Further research is needed to fully elucidate the impact of various hypertension treatments on cardiovascular outcomes.