Is insulin resistance linked to hypertension?

Michael W. Brands, John E. Hall, Henry L. Keen

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

1. The volume of work reporting insulin resistance in multiple forms of chronic hypertension has generated tremendous interest in whether this abnormality is an important factor in causing hypertension. Insulin resistance, however, is an imprecise term used interchangeably to describe widely disparate types of impairment in insulin action throughput the body and the type of insulin resistance has major ramifications regarding its potential for inducing long-term increases in blood pressure (BP). 2. Hepatic insulin resistance (impaired insulin-mediated suppression of hepatic glucose output) is the primary cause of fasting hyperinsulinaemia and is a cardinal feature of obesity hypertension. Evidence from chronic insulin infusion studies in rats suggests hyperinsulinaemia can increase BP under some conditions; however, conflicting evidence in humans and dogs leaves in question whether hyperinsulinaemia is a factor in hypertension induced by obesity. 3. Peripheral insulin resistance (impaired insulin-mediated glucose uptake, primarily of an acute glucose load in skeletal muscle) also present in obesity hypertension, but now reported in lean essential hypertension as well, is linked most notably to impaired insulin-mediated skeletal muscle vasodilation. This derangement has also been proposed as a mechanism through which insulin resistance can cause hypertension. 4. The present review will discuss the lack of experimental or theoretical support for that hypothesis and will suggest that a direct link between insulin resistance and BP control may not be the best way to envision a role for insulin resistance in cardiovascular morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)70-76
Number of pages7
JournalClinical and Experimental Pharmacology and Physiology
Volume25
Issue number1
DOIs
StatePublished - 1998
Externally publishedYes

Keywords

  • Blood flow
  • Blood pressure
  • Hypertension
  • Insulin
  • Insulin resistance
  • Obesity
  • Pressure natriuresis
  • Sodium excretion
  • Vasoconstriction

ASJC Scopus subject areas

  • Physiology
  • Pharmacology
  • Physiology (medical)

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