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Effects of NIDDM on Vascular Tone Regulation

  • Alain D. Baron
  • Helmut O. Steinberg
Chapter
Part of the Contemporary Biomedicine book series (CB, volume 15)

Abstract

The maintenance of vascular tone is extremely complex. Neural, endocrine, paracrine, and mechanical depressor and pressor forces all participate in a delicate balancing act to regulate vascular tone. The purpose of this chapter is to review the effect of noninsulin-dependent diabetes mellitus (NIDDM) on the regulation of vascular tone in humans. This issue is of great clinical importance because NIDDM is associated with an increased risk for hypertension and macrovascular disease, and is thus a major contributing factor to both cardiovascular morbidity and mortality (1). Importantly, both the risk and pattern of macrovascular disease in patients with NIDDM cannot be completely attributed to either the height of the blood pressure elevation or quantitative or qualitative abnormalities in circulating lipoprotein particles, suggesting that other factors, such as vascular wall integrity, might play an important role (1,2). NIDDM is characterized by insulin resistance, abnormal insulin secretion, and hyperglycemia (3). Because abnormalities in insulin secretion are not likely to play a direct role on the vasculature, these will not be discussed. In contrast, both insulin resistance and hyperglycemia are potentially critical factors in the dysregulation of vascular tone in NIDDM, and therefore, their effects on the vasculature will be discussed in some detail. The common phenotype of NIDDM is usually accompanied by obesity. Therefore, special attention will be paid to the effect of obesity per se on vascular tone. Finally, the biology of the vasculature is both organ- and tissue-specific, such that factors controlling vascular tone in the coronary vessels may be different than those in peripheral vessels. Because the greatest body of knowledge in this area has been garnered in peripheral limb arteries, the discussion will therefore largely focus on those vessels.

Keywords

Nitric Oxide Vascular Tone Total Peripheral Vascular Resistance Skeletal Muscle Blood Flow NIDDM Subject 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Alain D. Baron
  • Helmut O. Steinberg

There are no affiliations available

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