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Hypertension, coronary artery disease and insulin resistance—linked disorders with an impact on treatment
Author(s) -
Florkowski C.M.,
Harrison J.,
Kendall M.J.
Publication year - 1992
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.1992.tb01284.x
Subject(s) - medicine , thiazide , coronary artery disease , hyperinsulinemia , insulin resistance , cardiology , risk factor , diabetes mellitus , insulin , obesity , endocrinology , blood pressure
SUMMARY Coronary artery disease is a very common disorder for which hypertension is a well‐recognized risk factor. However many trials of antihypertensive therapy have failed to demonstrate a reduction in the incidence of coronary events. One explanation is that hypertension is a disorder associated with hyperinsulinaemia, obesity and non‐insulin dependent diabetes. Furthermore certain antihypertensive drugs, notably thiazide diuretics, increase the hyperinsulinaemia and thereby increase one of the other coronary risk factors. In this review the links between hypertension and hyperinsulinaemia are explored and the mechanisms whereby an increased plasma insulin can lead to the more rapid development of coronary artery disease are explained. These observations may influence the choice of drugs used to treat hypertension.