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Hypertension and Hormone Mechanisms pp 175–186Cite as

Insulin Resistance and Hypertension

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Part of the book series: Contemporary Endocrinology ((COE))

Abstract

The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) uses the term “metabolic syndrome” to describe a constellation of risk factors associated with insulin resistance, namely abdominal obesity, hypertension, dyslipidemia, and prothrombotic and proinflammatory states (1). These physiological abnormalities are produced through the interaction of genetic, hormonal, and lifestyle factors. Individuals with metabolic syndrome have a greatly heightened risk of developing diabetes, coronary heart disease, stroke, and renal disease, as well as increased all-cause and cardiovascular mortality rates. Hypertension, one of the most prevalent components of metabolic syndrome, contributes directly to many of these complications. The relationship between blood pressure and risk of cardiovascular disease (CVD) events is continuous, consistent, and independent; the higher the blood pressure, the greater the chance of myocardial infarction, heart failure, stroke, and renal disease. The CVD risk escalates further when other risk factors are present, as in patients with metabolic syndrome.

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References

  1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. (2001) Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285(19), 2486–2497.

    Article  Google Scholar 

  2. Ford, E. S., Giles, W. H., and Dietz, W. H. (2002) Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey. JAMA 287(3), 356–359.

    Article  PubMed  Google Scholar 

  3. Sowers, J. R. (2004) Insulin resistance and hypertension. Am. J. Physiol. Heart Circ. Physiol. 286, H1597–H1602.

    Article  CAS  PubMed  Google Scholar 

  4. Balletshofer, B. M., Rittig, K., Enderle, M. D., et al. (2000) Endothelial dysfunction is detectable in young normotensive first-degree relatives of subjects with type 2 diabetes in association with insulin resistance. Circulation 101, 1780–1784.

    CAS  PubMed  Google Scholar 

  5. Goff, D. C. Jr., Zaccaro, D. J., Haffner, S. M., et al. (2003) Insulin sensitivity and the risk of incident hypertension: insights from the insulin resistance atherosclerosis study. Diab. Care 26, 805–809.

    Article  Google Scholar 

  6. Ferrannini, E. (2003) Analysis of data on insulin resistance from the European group for the study of insulin resistance: focus on obesity and hypertension. Endocrinol. Pract. 9, 43–49.

    Google Scholar 

  7. McFarlane, S., Kumar, A., and Sowers, J. R. (2003) Mechanisms by which angiotensin-converting enzyme inhibitors prevent diabetes and cardiovascular disease. Am. J. Cardiol. 91(Suppl), 30H–37H.

    Article  CAS  PubMed  Google Scholar 

  8. Perticone, F., Ceravolo, R., Iacopino, S., et al. (2001) Relationship between angiotensin-converting enzyme gene polymorphism and insulin resistance in never-treated hypertensive patients. J. Clin. Endocrinol. Metab. 86, 172–178.

    Article  CAS  PubMed  Google Scholar 

  9. Blendea, M. C., Jacobs, D., Stump, C. S., et al. (2005) Abrogation of oxidative stress improves insulin sensitivity in the Ren2 Rat model of tissue angiotensin II overexpression. Am. J. Physiol. Endocrinol. Metab. 288(2), E353–E359.

    Article  CAS  PubMed  Google Scholar 

  10. Sowers, J. R. and Stump, C. S. (2004) Insights into the biology of diabetic vascular disease: What’s new? Am. J. Hypertens. 17(11 Suppl), S2–S6.

    Article  Google Scholar 

  11. Park, Y. W., Zhu, S., Palaniappan, L., et al. (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the third national health and nutrition examination survey, 1988–1994. Arch. Intern. Med. 163(4), 427–436.

    Article  PubMed  Google Scholar 

  12. Resnick, H. E. (2002) Metabolic syndrome in American Indians. Diab. Care 25(7), 1246–1247.

    Article  Google Scholar 

  13. Ninomiya, J. K., L’ltalien, G., Criqui, M. H., et al. (2004) Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation 109(1), 42–46.

    Article  PubMed  Google Scholar 

  14. Bonora, E., Targher, G., Formentini, G., et al. (2004) The metabolic syndrome is an independent predictor or cardiovascular disease in type 2 diabetic subjects. Prospective data from the verona diabetes complications study. Diabet. Med. 21(1), 52–58.

    Article  CAS  PubMed  Google Scholar 

  15. Wong, N. D., Pio, J. R., Franklin, S. S., et al. (2003) Preventing coronary events by optimal control of blood pressure and lipids in patients with the metabolic syndrome. Am. J. Cardiol. 91(12), 1421–1426.

    Article  PubMed  Google Scholar 

  16. Chobanian, A. V., Bakris, G. L., Black, H. R., et al. (2003) Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42(6), 1206–1252.

    Article  CAS  PubMed  Google Scholar 

  17. American Diabetes Association. (2004) Hypertension management in adults with diabetes. Diab. Care 27(Suppl 1), S65–S67.

    Google Scholar 

  18. Knowler, W. C., Barrett-Connor, E., Fowler, S. E., et al. (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl. J. Med. 346(6), 393–403.

    Article  CAS  PubMed  Google Scholar 

  19. Grundy, S. M., Brewer, H. B. Jr, Cleeman, J. I., et al. (2004) Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109(3), 433–438.

    Article  PubMed  Google Scholar 

  20. Hansson, L., Zanchetti, A., Carruthers, S. G., et al. (1998) Effects of intensive blood pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. Lancet 351(9118), 1755–1762.

    Article  CAS  PubMed  Google Scholar 

  21. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. (2002) Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. The antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). JAMA 288(23), 2981–2997.

    Article  Google Scholar 

  22. The Heart Outcomes Prevention Evaluation Study Investigators. (2002) Effects of an angiotensinconverting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl. J. Med. 342(3), 145–153.

    Article  Google Scholar 

  23. Heart Outcomes Prevention Evaluation Study Investigators. (2000) Effects of ramipril on cardiovascular and microvascular outcomes in people with Diabetes mellitus: results of the HOPE study and MICROHOPE substudy. Lancet 355(9200), 253–259.

    Article  Google Scholar 

  24. Lewis, E. J., Hunsicker, L. G., Clarke, W. R., et al. (2001) Renoprotective effect of the angiotensinreceptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl. J. Med. 345(12), 851–860.

    Article  CAS  PubMed  Google Scholar 

  25. Brenner, B. M., Cooper, M. E., de Zeeuw, D., et al. (2001) Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl. J. Med. 345(12), 861–869.

    Article  CAS  PubMed  Google Scholar 

  26. Parving, H. H., Lehnert, H., Brochner-Mortensen, J., et al. (2001) The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl. J. Med. 345(12), 870–878.

    Article  CAS  PubMed  Google Scholar 

  27. Viberti, G. and Wheeldon, N. M. (2002) Microalbuminuria reduction with valsartan in patients with type 2 Diabetes mellitus: a blood pressure-independent effect. Circulation 106(6), 672–678.

    Article  CAS  PubMed  Google Scholar 

  28. Dahlöf, B., Devereux, R. B., Kjeldsen, S. E., et al. (2002) Cardiovascular morbidity and mortality in the Losartan intervention for endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 359(9311), 995–1003.

    Article  PubMed  Google Scholar 

  29. Pfeffer, M. A., Swedberg, K., Granger, C. B., et al. (2003) Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall Programme. Lancet 362(9386), 759–766.

    Article  CAS  PubMed  Google Scholar 

  30. Douglas, J. G., Bakris, G. L., Epstein, M., et al. (2003) Management of high blood pressure in African Americans: consensus statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Arch. Intern. Med. 163(5), 525–541.

    Article  PubMed  Google Scholar 

  31. Chen, J., Muntner, P., Hamm, L. L., et al. (2004) The metabolic syndrome and chronic kidney disease in U.S. adults. Ann. Intern. Med. 140(3), 167–174.

    PubMed  Google Scholar 

  32. Hillege, H. L., Fidler, V., Diercks, G. F., et al. (2002) Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation 106(14), 1777–1782.

    Article  CAS  PubMed  Google Scholar 

  33. Isomaa, B., Almgren, P., Tuomi, T., et al. (2001) Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diab. Care 24(4), 683–689.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Diabetes Center, Departments of Medicine and Physiology, University of Arizona, Tucson, AZ

    James R. Sowers MD

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  1. James R. Sowers MD
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Editors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA

    Robert M. Carey MD, MACP (David A. Harrison III Distinguished Professor of Medicine) (David A. Harrison III Distinguished Professor of Medicine)

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© 2007 Humana Press Inc., Totowa, NJ

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Sowers, J.R. (2007). Insulin Resistance and Hypertension. In: Carey, R.M. (eds) Hypertension and Hormone Mechanisms. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59259-987-5_11

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  • DOI: https://doi.org/10.1007/978-1-59259-987-5_11

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-408-1

  • Online ISBN: 978-1-59259-987-5

  • eBook Packages: MedicineMedicine (R0)

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