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Is insulin resistance linked to hypertension?
M W Brands1, J E Hall, H L Keen
1Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson 39216, USA. brands@fiona.umsmed.edu
Clinical and Experimental Pharmacology & Physiology
|March 11, 1998
Summary
Insulin resistance is complex and its direct link to hypertension is debated. Different types of insulin resistance, like hepatic and peripheral, have varying impacts on blood pressure (BP) and cardiovascular health.
Area of Science:
- Endocrinology
- Cardiovascular Physiology
- Metabolic Syndrome
Background:
- Chronic hypertension is associated with insulin resistance, prompting investigation into its causal role.
- Insulin resistance is an imprecise term encompassing diverse impairments in insulin action, with type significantly influencing potential to elevate blood pressure (BP).
Framework:
- Hepatic insulin resistance, characterized by impaired suppression of hepatic glucose output, causes hyperinsulinaemia and is key in obesity-related hypertension.
- Peripheral insulin resistance, affecting glucose uptake in skeletal muscle, is implicated in both obesity and lean essential hypertension, potentially through impaired vasodilation.
Implementation:
- Review of experimental and theoretical evidence regarding the hypothesis that insulin resistance directly causes hypertension.
- Analysis of conflicting data on hyperinsulinaemia's effect on BP in humans and dogs.
Implications:
- Challenges the direct link between insulin resistance and BP control as the primary mechanism for cardiovascular risk.
- Suggests a re-evaluation of how insulin resistance contributes to cardiovascular morbidity and mortality.