Insulin sensitivity in the pathogenesis of hypertension and hypertensive complications

L. Landsberg*

*Corresponding author for this work

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Epidemiologic and clinical studies suggest an association between hyperinsulinemia (and insulin resistance) and hypertension. This relationship is not present in secondary forms of hypertension and may persist despite adequate antihypertensive therapy. Normotensive offspring of hypertensive parents are also, as a group, insulin resistant and hyperinsulemic. The association of hyperinsulinemia (and insulin resistance) with hypertension is more marked in the obese but present in lean hypertensives as well. Physiological mechanisms by which insulin might increase blood pressure include sympathetic nervous system stimulation and enhancement of renal sodium reabsorption. Evidence exists linking both of these mechanisms to hypertension. Insulin is also independently associated with myocardial infarction and microalbuminuria, two long term complications of high blood pressure. Experimentally induced decreases in insulin resistance and hyperinsulinemia, furthermore, have been associated with decreased blood pressure. In summary, the evidence suggests that hyperinsulinemia (and insulin resistance) exerts a pro-hypertensive effect that may be important in the pathogenesis of hypertension and hypertensive complications in some patients with essential hypertension.

Original languageEnglish (US)
Pages (from-to)337-346
Number of pages10
JournalClinical and Experimental Hypertension
Volume18
Issue number3-4
DOIs
Publication statusPublished - Jan 1 1996

    Fingerprint

Keywords

  • catecholamines
  • hypertension
  • insulin
  • obesity
  • sympathetic nervous system

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology

Cite this