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Hypertension as a metabolic disorder--an overview
U Smith1, S Gudbjörnsdottir, K Landin
1Department of Medicine II, Sahlgrenska Hospital, University of Göteborg, Sweden.
Insights
Insulin resistance and high insulin levels (hyperinsulinaemia) are linked to hypertension and metabolic issues. While they may contribute to high blood pressure, other factors like genetics also play a role.
Area of Science:
- Cardiovascular Science
- Metabolic Science
- Endocrinology
Background:
- Hypertension is associated with metabolic disturbances like obesity and impaired glucose tolerance.
- Metabolic abnormalities and impaired fibrinolysis, including elevated plasminogen activator inhibitor type 1 (PAI-1), are observed in hypertensive individuals, even non-obese ones.
- Insulin resistance and hyperinsulinaemia are implicated in the metabolic and fibrinolytic abnormalities seen in essential hypertension.
Purpose of the Study:
- To explore the complex relationship between insulin, insulin resistance, hyperinsulinaemia, and hypertension.
- To investigate the potential causal role of hyperinsulinaemia in hypertension.
- To clarify the association between metabolic factors and hypertension.
Main Methods:
- Review of existing evidence linking hypertension, metabolic syndrome, and insulin signaling.
- Analysis of studies investigating insulin resistance and hyperinsulinaemia in hypertensive and normotensive populations.
- Exploration of the role of PAI-1 and fibrinolysis in the context of metabolic abnormalities and hypertension.
Main Results:
- Insulin resistance and hyperinsulinaemia are suggested to play a role in the development of hypertension.
- Metabolic and fibrinolytic abnormalities are present in hypertensive individuals, including those who are not obese.
- Hyperinsulinaemia can occur independently of hypertension, indicating the involvement of other contributing factors.
Conclusions:
- Insulin resistance and hyperinsulinaemia are likely contributors to hypertension.
- The relationship between insulin and hypertension is complex and requires further investigation.
- Genetic susceptibility and other factors may be important in the development of hypertension, independent of or in conjunction with hyperinsulinaemia.
Abstract:
Hypertension is related to several conditions with abnormalities in carbohydrate and lipid metabolism, such as obesity and impaired glucose tolerance. However, perturbed metabolism is also seen in non-obese hypertensive individuals. In addition, hypertension is linked to impaired fibrinolysis and elevated levels of the plasminogen activator inhibitor of endothelial type (PAI-1). Insulin resistance and hyperinsulinaemia in essential hypertension may be an important cause of these metabolic and fibrinolytic abnormalities. Whether hyperinsulinaemia is the cause of hypertension is currently unknown. However, it is clear that the relationship between hypertension and insulin is complex, and further studies are required to clarify this association. Based on the evidence states, it is suggested that insulin resistance and hyperinsulinaemia play a role in hypertension. However, it is also clear that hyperinsulinaemia occurs in the absence of hypertension, which suggests that other factors, such as genetic susceptibility, may be important.