[Hypertension in the patients with impaired glucose tolerance]

Diabetes mellitus is commonly associated with hypertension. Association of diabetes mellitus and hypertension predispose an individual to atherosclerotic cardiovascular disease. Hyperinsulinemia is one of the important candidates to cause hypertension in the patients with diabetes mellitus. Several mechanisms mediated by hyperinsulinemia can be entertained as follows: 1) sodium and water retention, 2) increased sympathetic nerve activity and reduced catecholamine clearance, 3) increased intracellular calcium concentration and reduced magnesium concentration, 4) increased coagulant activity and impaired fibrinolytic activity, 5) impaired endothelium-dependent NO synthesis and release, 6) increased vascular responsiveness for the vasoactive substrates, 7) increased proliferation of vascular smooth muscle cell by activation of protein kinase C or mediated by insulin and IGF-1 action.