METABOLIC ABNORMALITIES IN HYPERTENSION

Hypertension is often accompanied by a host of metabolic defects, Inve stigations have shown an association between insulin resistance, hyper insulinemia, central/visceral obesity, and hypertension, Recent intere st has focused on the fact that untreated hypertensive individuals hav e compensatory hyperinsulinemia, are resistant to insulin-mediated glu cose uptake, and frequently have coexisting lipid abnormalities, Data from prospective studies appear to indicate that fasting hyperinsuline mia is an independent predictor of coronary artery disease, Additional ly, there is evidence that hyperinsulinemia and diabetes eliminate the normal sex differences in the prevalence of coronary artery disease, The salutary effects of ovarian hormones on the prevalence of hyperten sion and cardiovascular disease in postmenopausal women are well estab lished. Hyperandrogenism, in particular elevated serum levels of dehyd roepiandrosterone sulfate, is believed to be a risk factor promoting s ex-specific impairments of glucose and lipid metabolism, obesity, and hypertension in women. Clinical and epidemiologic evidence have linked elevated blood pressure to disturbances in lipoprotein metabolism, fi brinolytic activity, plasminogen activation inhibitor levels, and dysl ipidemia, This review briefly presents the current understanding of va rious metabolic disturbances associated with hypertension, the pathoph ysiologic mechanisms involved, and the significance of the interplay b etween them relative to the complications of this disease.