Obesity hypertension, salt sensitivity and insulin resistance.
OBJECTIVE
To review human and animal data describing the complex interrelation between obesity hypertension, salt-sensitivity and insulin resistance.


RESULTS
The first part of the article reviews the information available in the literature defining obesity hypertension as a salt sensitive form of hypertension and that links obesity hypertension to the presence of insulin. The second part reviews the four factors frequently cited as possible causes for this sodium retention: insulin resistance, alteration in the renin-angiotensin system, altered vascular responsiveness and alterations in the sympathetic nervous system. Special emphasis is given in an attempt to explain how each of these four factors can change pressure-natriuresis.


CONCLUSIONS
There is clearly a strong relationship between obesity hypertension, sodium sensitivity and insulin resistance. The exact mechanism responsible for linking these three conditions is still unknown. However, there is ample evidence to suggest that insulin resistance, altered vascular responsiveness, altered function of the renin-angiotensin aldosterone system and altered function of the sympathetic nervous system are important in these three conditions. Further investigation is warranted to completely elucidate the complex relationship between insulin resistance, obesity hypertension and sodium sensitivity.
Rocchini
A P
AP
Michigan Congenital Heart Center C.S. Mott Children's Hospital University of Michigan Health Systems, F1310 MCHC, Box 0204, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
D000818:Animals; D015897:Comorbidity; D004285:Dogs; D006801:Humans; D006946:Hyperinsulinism / Q000503:physiopathology; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology; D007333:Insulin Resistance; D007668:Kidney / Q000378:metabolism; D009318:Natriuresis; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D012964:Sodium / Q000378:metabolism*; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage / Q000009:adverse effects; D013564:Sympathetic Nervous System / Q000503:physiopathology
D017673:Sodium Chloride, Dietary; D012964:Sodium