Insulin Resistance in Hypertension: A Focused Review
Autor: | Gary W. Edelson, James R. Sowers |
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Rok vydání: | 1993 |
Předmět: |
medicine.medical_specialty
Sympathetic nervous system Renal sodium reabsorption business.industry Insulin medicine.medical_treatment Calcium channel Lipid metabolism General Medicine Pharmacology medicine.disease Coronary artery disease Endocrinology Insulin resistance medicine.anatomical_structure Internal medicine Hypertension medicine Hyperinsulinemia Animals Humans Obesity Insulin Resistance business |
Zdroj: | The American Journal of the Medical Sciences. 306:345-347 |
ISSN: | 0002-9629 |
DOI: | 10.1097/00000441-199311000-00014 |
Popis: | The associations between insulin resistance, hyperinsulinemia, and hypertension are well recognized. The insulin resistance and hyperinsulinemia associated with hypertension is the result of increased renal tubular sodium reabsorption, increased sympathetic nervous system activity, and increased arterial wall smooth muscle reactivity. In insulin resistant states, intracellular calcium and sodium accumulation is thought to be the fundamental underlying abnormality. These is evidence that hyperinsulinemia is an independent risk factor for coronary artery disease. Therefore, therapeutic considerations in patients with insulin resistance should include nonpharmacologic methods for increasing insulin sensitivity as well as avoiding the deleterious effects on insulin action and lipid metabolism of various antihypertensive medications. Of the currently available antihypertensives therapies, the angiotensin-converting enzyme inhibitors, the alpha antagonists, and the calcium channel blockers are the most rational choices for treating patients with hypertension with evidence of coexisting insulin resistance. |
Databáze: | OpenAIRE |
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