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Am J Physiol Heart Circ Physiol 286: H1597-H1602, 2004; doi:10.1152/ajpheart.00026.2004
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EDITORIAL

Insulin resistance and hypertension

James R. Sowers

Departments of Internal Medicine and Physiology/Pharmacology, University of Missouri-Columbia, H. S. Truman Veterans Affairs Medical Center, Columbia, Missouri 65212

Submitted 8 January 2004 ; accepted in final form 12 January 2004

ABSTRACT

Diminished insulin (Ins) sensitivity is a characteristic feature of various pathological conditions such as the cardiometabolic syndrome, Type 2 diabetes, and hypertension. Persons with essential hypertension are more prone than normotensive persons to develop diabetes, and this propensity may reflect decreased ability of Ins to promote relaxation and glucose transport in vascular and skeletal muscle tissue, respectively. There are increasing data suggesting that ANG II acting through its ANG type 1 receptor inhibits the actions of Ins in vascular and skeletal muscle tissue, in part, by interfering with Ins signally through phosphatidylinositol 3-kinase (PI3K) and its downstream protein kinase B (Akt) signaling pathways. This inhibitory action of ANG II is mediated, in part, through stimulation of RhoA activity and oxidative stress. Activated RhoA and increased reactive oxygen species inhibition of PI3K/Akt signaling results in decreased endothelial cell production of nitric oxide, increased myosin light chain activation with vasoconstriction, and reduced skeletal muscle glucose transport.

angiotensin II; blood pressure; glucose utilization



Address for reprint requests and other correspondence: J. R. Sowers, Prof. of Medicine and Physiology/Pharmacology, Univ. of Missouri-Columbia, Dept. of Internal Medicine, MA410 Health Science Center, One Hospital Dr., Columbia, MO 65212 (E-mail: sowersj{at}health.missouri.edu).




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