Hyperinsulinemia, insulin resistance, and hyperglycemia: Contributing factors in the pathogenesis of hypertension and atherosclerosis

James R. Sowers, Paul R Standley, Jeffrey L. Ram, Scott Jacober, Lori Simpson, Kelly Rose

Research output: Contribution to journalArticle

132 Citations (Scopus)

Abstract

Subtle abnormalities of carbohydrate metabolism and overt diabetes mellitus are both associated with a substantial increase in the prevalence of hypertension and the accelerated development of atherosclerosis. Hypertension is also a presumed independent risk factor for atherosclerosis, although some of the atherogenic properties of hypertension may be related to the recently recognized subtle metabolic abnormalities commonly found in persons with essential hypertension. The results of epidemiologic studies suggest that the elevated fasting and postprandial insulin levels that often occur in patients with essential hypertension, as well as in patients with type II diabetes mellitus, are an independent risk factor for atherosclerotic cardiovascular disease. Elevated glucose levels in patients with diabetes and hypertension appear to contribute to the acceleration of atherosclerosis, perhaps through toxic effects on the vascular endothelium. Other cardiovascular risk factors that are accentuated in persons with carbohydrate intolerance and hypertension include abnormalities in platelet function, clotting factors, the fibrinolytic system, and dyslipidemia. The goals of both nonpharmacologic and pharmacologic therapy for patients with abnormal carbohydrate metabolism and hypertension are to decrease cardiovascular risk as well as lower blood pressure.

Original languageEnglish (US)
Pages (from-to)260-270
Number of pages11
JournalAmerican Journal of Hypertension
Volume6
Issue number7 PART 2
StatePublished - Jul 1993
Externally publishedYes

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Hyperinsulinism
Hyperglycemia
Insulin Resistance
Atherosclerosis
Hypertension
Carbohydrate Metabolism
Blood Coagulation Factors
Poisons
Vascular Endothelium
Dyslipidemias
Type 2 Diabetes Mellitus
Epidemiologic Studies
Fasting
Diabetes Mellitus
Cardiovascular Diseases
Blood Platelets
Insulin
Blood Pressure
Glucose

Keywords

  • atherosclerosis
  • hyperglycemia
  • Hyperinsulinemia
  • insulin resistance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hyperinsulinemia, insulin resistance, and hyperglycemia : Contributing factors in the pathogenesis of hypertension and atherosclerosis. / Sowers, James R.; Standley, Paul R; Ram, Jeffrey L.; Jacober, Scott; Simpson, Lori; Rose, Kelly.

In: American Journal of Hypertension, Vol. 6, No. 7 PART 2, 07.1993, p. 260-270.

Research output: Contribution to journalArticle

Sowers, James R. ; Standley, Paul R ; Ram, Jeffrey L. ; Jacober, Scott ; Simpson, Lori ; Rose, Kelly. / Hyperinsulinemia, insulin resistance, and hyperglycemia : Contributing factors in the pathogenesis of hypertension and atherosclerosis. In: American Journal of Hypertension. 1993 ; Vol. 6, No. 7 PART 2. pp. 260-270.
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