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Hypertension and insulin disorders

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Abstract

Insulin resistance and/or compensatory hyperinsulinemia are associated with hypertension, obesity, dyslipidemia, and glucose intolerance. Insulin resistance and hyperinsulinemia are considered to increase blood pressure through sympathetic nervous system activation, renin-angiotensin system stimulation, and vascular smooth muscle cell proliferation. Leptin, magnesium ions, nitric oxide, endothelin, peroxisome proliferator-activated receptor γ, and tumor necrosis factor-α also modulate blood pressure. Decreasing insulin resistance by lifestyle modification including diet, weight loss, and physical exercise has been shown to reduce blood pressure. Angiotensin-converting enzyme inhibitors have a beneficial effect on insulin resistance. On the other hand, the angiotensin II antagonist, losartan, does not affect insulin sensitivity. The selective α1-blockers have a favorable metabolic profile producing increases in insulin sensitivity. A short-acting type calcium channel blocker seems to decrease insulin sensitivity. On the other hand, long-acting type calcium channel blockers improve insulin sensitivity. Thiazide diuretics and most of the β-blockers decrease insulin sensitivity. Vasodilatory β-blockers have been reported to improve insulin sensitivity. Use of low-dose diuretics avoids the adverse effects seen with conventional doses.

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  1. Division of Internal Medicine, Ajina Tsuchiya Hospital, 4-51-1, 738-0054, Ajina Hatsukaichi, Japan

    Michinori Imazu MD

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Imazu, M. Hypertension and insulin disorders. Current Science Inc 4, 477–482 (2002). https://doi.org/10.1007/s11906-002-0029-y

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