Hypertension as a disease of carbohydrate and lipoprotein metabolism

Article Abstract:

The hormone insulin is essential for the metabolism of sugar in the body. When insulin is not produced, glucose cannot be utilized by the cells and diabetes mellitus, a disorder of sugar intolerance, results. Abnormal metabolism of glucose, a simple sugar, and insulin can be found in patients with high blood pressure. This glucose intolerance may be caused by the drug therapy used to treat high blood pressure, but it has also been found among patients with high blood pressure who are not receiving antihypertensive medication. It is suggested that abnormal insulin and glucose metabolism may be involved in the development of high blood pressure. When insulin is given to untreated patients with high blood pressure, glucose is still not well utilized. The patient is considered insulin-resistant and hyperinsulinemia, high insulin in the blood, ensues. This condition of insulin resistance and hyperinsulinemia has been demonstrated in rats with high blood pressure. Animals with normal glucose tolerance but with hyperinsulinemia have higher blood pressures when compared with those with normal insulin levels. In an experiment with sugar-fed rats, methods of preventing hyperinsulinemia from developing also prevented blood pressure increases. High blood pressure is known to increase the risk for coronary heart disease. Increased insulin and triglycerides contribute to the risk of coronary heart disease in patients with high blood pressure. Treatment of hypertension with blood pressure-lowering drugs, however, has not effectively lowered the mortality rate from coronary artery disease as originally thought, and may actually contribute to the risk. It is postulated therefore that abnormal sugar and lipoprotein metabolism may be involved in the development and course of hypertension.

Risk factors, Coronary heart disease, Diabetes, Diabetes mellitus, Carbohydrates, Lipoproteins

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Insulin resistance, hyperinsulinemia, and hypertriglyceridemia in the etiology and clinical course of hypertension

Article Abstract:

Hypertension, or high blood pressure, has a wide variety of deleterious consequences including increased incidence of coronary artery disease, acute myocardial infarction (heart attack) and stroke. In many cases, the underlying cause of hypertension remains unknown, and the disease symptoms are treated with drugs that cause relaxation of the blood vessels, reduction of blood volume, or include other strategies for reducing blood pressure without addressing the causal agent. It has been noted that a common characteristic of hypertensive patients is disturbed carbohydrate (sugar) and lipid (fat) metabolism. In particular, many hypertensive patients have a condition known as insulin resistance, in which the effects of insulin on glucose metabolism are severely blunted. Insulin resistance is also common among obese patients and patients with non-insulin-dependent diabetes mellitus (NIDDM), conditions that are often associated with hypertension. The metabolic disturbances seen in hypertensive patients are known to be independent risk factors for the development of coronary artery disease and other cardiovascular conditions. Symptomatic treatment of hypertension often does not reverse the metabolic alterations, and this may explain why antihypertensive therapy often does not appear to decrease the risk of developing coronary artery disease. Controversy exists concerning which alteration is primary in these conditions, but evidence is accumulating that high levels of insulin, as observed in insulin-resistant patients, may be involved in the development of hypertension. (Consumer Summary produced by Reliance Medical Information, Inc.)

Insulin resistance, Lipid metabolism disorders, Lipidosis

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The aging hypertensive kidney: pathophysiology and therapeutic options

Article Abstract:

Hypertensive arteriolar nephrosclerosis is a complication of high blood pressure (hypertension), which primarily affects the elderly. This condition, in which the arterioles (tiny arteries) of the kidney are destroyed, causes 26 percent of the deaths from end-stage renal (kidney) disease (ESRD). The structural and functional changes of aging kidneys are described, and are related to impairments caused by hypertension. It has generally been accepted that treatment of systemic hypertension protects the kidney, but definitive data are lacking. Experiments indicate that drugs that reduce systemic pressure and glomerular capillary pressure appear to protect the kidneys, compared with drugs that only reduce systemic pressure. Both angiotensin-converting enzyme inhibitors and calcium channel blockers act in ways that suggest that they will prevent kidney complications. The prevention of the progression of advanced hypertensive arteriolar nephrosclerosis to ESRD seems to depend on controlling both systemic blood pressure and the pressure on capillaries in the kidney. Kidney protection is best obtained by maintaining a low-protein diet and the use of either calcium channel blockers or angiotensin-converting enzyme inhibitors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Physiological aspects, Demographic aspects, ACE inhibitors, Angiotensin converting enzyme inhibitors, Kidney diseases, Calcium channel blockers, Nephrosclerosis

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