Diabetic vascular disease and hypertension.
There is increasing evidence that essential hypertension is associated with a panoply of metabolic abnormalities. Included in these abnormalities are insulin resistance, dyslipidemia, enhanced coagulation, and decreased fibrinolytic activity, microalbuminuria, and platelet abnormalities and endothelial dysfunction. Visceral obesity appears to be the most common and predictive underlying factor for all of these metabolic abnormalities accompanying hypertension as well as increased cardiovascular disease (CVD) risk. As the prevalence of obesity is increasing, there is cause for concern that CVD increases will parallel this risk factor, particularly in especially high-risk populations, such as African-American women. Other important risk factors, such as increased oxidative stress, may require special therapeutic strategies, including the use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin blockers as cornerstones of antihypertensive drug therapy.
Hamaty
M
M
Division of Endocrinology, Metabolism and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Lamberti
M
M
Sowers
J R
JR
D018674:Adrenergic Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003925:Diabetic Angiopathies / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005006:Ethnicity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D007328:Insulin / Q000097:blood; D008297:Male; D012307:Risk Factors
D018674:Adrenergic Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D007328:Insulin