Essential hypertension, metabolic disorders, and insulin resistance

Hypertension, or high blood pressure, is a recognized risk factor for the development of atherosclerosis, which is characterized by narrowing and hardening of the arteries and results from the accumulation of fatty calcified plaques on the inner surface of arterial walls. In Western societies, medical attention has become so focused on hypertension and its treatment that, in many cases, blood pressure reduction is considered to be the highest priority health issue, which often is not in the best interests of the patient. Long-term clinical trials have shown that lowering blood pressure benefits some, but not all, patients. Many of the drugs used to reduce blood pressure (such as diuretics and beta blockers) have adverse metabolic side effects, which are often as deleterious as hypertension itself. Hypertension, especially essential hypertension (high blood pressure that is not secondary to some other identifiable cause), often occurs concomitantly with obesity, glucose intolerance (inability to metabolize glucose), hyperinsulinemia (elevated blood levels of insulin), and disorders of lipid (fat) metabolism. Evidence is accumulating that each of these disorders forms part of a so-called atherogenic syndrome (resulting in the development of atherosclerosis). Insulin resistance occurs when the tissues of the body, which ordinarily respond to insulin by taking up glucose, become much less responsive to the effects of this hormone. It has been proposed that insulin resistance may be a common element in all the above-mentioned components of the atherogenic syndrome, and that treatment strategies should not seek to address one symptom in isolation, but rather should take into consideration the metabolic profile of the patient. In other words, the goal of treatment should be to reduce all atherogenic risk factors. This approach would presumably be reflected in increased insulin sensitivity, and a reduced risk of developing atherosclerosis. (Consumer Summary produced by Reliance Medical Information, Inc.)