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Review Article
Mechanisms of Disease
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Volume 334:374-382 February 8, 1996 Number 6
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Hypertension and Associated Metabolic Abnormalities — The Role of Insulin Resistance and the Sympathoadrenal System
Gerald M. Reaven, M.D., Hans Lithell, M.D., and Lewis Landsberg, M.D.

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Abnormalities of glucose, insulin, and lipoprotein metabolism are common in patients with hypertension. These changes can also be discerned in normotensive first-degree relatives of hypertensive patients. They are not present in patients with secondary forms of hypertension, do not necessarily improve when blood pressure is lowered pharmacologically, and may even be made worse by some forms of antihypertensive treatment. These metabolic abnormalities may play a part in both the pathogenesis and the complications of hypertension in many patients. We hypothesize that the metabolic abnormalities are linked to the hypertension by a pathophysiologic process that involves the sympathoadrenal system and exerts . . . [Full Text of this Article]

Glucose, Insulin, and Lipoproteins in Patients with Hypertension

Hypertension and Metabolic Disorders

Metabolic Abnormalities and the Clinical Course of Patients with Hypertension

Dyslipidemia and Coronary Heart Disease

Insulin Resistance, Sympathoadrenal Activity, and Hypertension

Diet and Sympathetic Nervous System Activity

Role of Insulin

Dietary Thermogenesis

Obesity-Related Hypertension

Insulin and Sympathetic Activity in Hypertension

Insulin Resistance in Nonobese Patients with Hypertension

Vasodilator Actions of Insulin

Dyslipidemia

Effects of Antihypertensive Drugs on the Sympathetic Nervous System

{beta}-Adrenergic Antagonists

{alpha}1-Adrenergic Antagonists

Blood Flow

Other Antihypertensive Drugs

Effects of Antihypertensive Drugs on Lipoprotein Metabolism

{beta}-Adrenergic Antagonists

{alpha}1-Adrenergic Antagonists

Conclusions


Source Information

From Stanford University, Palo Alto, Calif. (G.M.R.); Uppsala University, Uppsala, Sweden (H.L.); and Northwestern University, Chicago (L.L.).

Address reprint requests to Dr. Landsberg at the Department of Medicine, Northwestern University Medical School and Northwestern Memorial Hospital, Wesley Pavilion 296, 250 E. Superior St., Chicago, IL 60611.

References


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Extract | Full Text  
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