Why the study?
How do the links between hypertension, hyperinsulinaemia, and antihypertensive drugs impact the development of coronary artery disease?
How do the links between hypertension, hyperinsulinaemia, and antihypertensive drugs impact the development of coronary artery disease?
Highlights the importance of considering the metabolic effects of antihypertensive drugs, particularly their impact on insulin resistance, to effectively reduce coronary artery disease risk.
Hyperinsulinemia may accelerate CAD in hypertension; hypothesis-generating for thiazide metabolic effects and requires prospective validation.
Coronary artery disease is a very common disorder for which hypertension is a well-recognized risk factor. However many trials of antihypertensive therapy have failed to demonstrate a reduction in the incidence of coronary events. One explanation is that hypertension is a disorder associated with hyperinsulinaemia, obesity and non-insulin dependent diabetes. Furthermore certain antihypertensive drugs, notably thiazide diuretics, increase the hyperinsulinaemia and thereby increase one of the other coronary risk factors. In this review the links between hypertension and hyperinsulinaemia are explored and the mechanisms whereby an increased plasma insulin can lead to the more rapid development of coronary artery disease are explained. These observations may influence the choice of drugs used to treat hypertension.
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Florkowski et al. (1992) studied this question.
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