Hypertension in people with diabetes and the metabolic syndrome: Pathophysiologic insights and therapeutic update

Ganne, Sudha; Arora, Sachin; Dotsenko, Olena; McFarlane, Samy I.; Whaley‐Connell, Adam

doi:10.1007/s11892-007-0033-3

Cited by 16 publications

(11 citation statements)

References 75 publications

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“…Evidence demonstrates a relationship between hypertension and type 2 diabetes mellitus, and several vascular and metabolic abnormalities [35]. Yugar-Toledo et al [36] found that patients with diabetes showed an increase in plasma nitrite/nitrate levels, suggesting an association with excessive production and/or inactivation of NO.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Jalali

Phadke

2011

Ind J Clin Biochem

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Conditions like hypertension, atherosclerosis and diabetes are known to be the result of endothelial dysfunction which could begin early in the life of an individual. The markers of endothelial dysfunction studied in the present work are plasma hemoglobin, serum high sensitivity C-reactive protein (hsCRP) and plasma nitrite and nitrate. We studied the onset of endothelial dysfunction with increase in age as well as in disease condition like newly detected hypertensives and of hypertensive diabetic patients. The mean plasma hemoglobin and hsCRP values were found to increase with age. hsCRP and plasma hemoglobin levels were significantly higher in patient groups as compared to aged-matched controls. On the other hand nitrate and nitrite was significantly higher in patients who suffered from both diabetes and hypertension together and nitrate values were significantly lower in patients who suffered from hypertensive alone. Plasma hemoglobin and hsCRP are associated with endothelial dysfunction and increases both with age as well as in disease condition.

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Section: Discussionmentioning

confidence: 99%

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Jalali

Phadke

2011

Ind J Clin Biochem

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“…In complement of functional and molecular evidences for impairment of BK Ca channels in type-2 diabetic CASMCs, an experimental model was duplicated by feeding rats with high fat and glucose diet followed by injecting small dose STZ in the present study. This relatively new model is characterized by insulin resistance, hyperglycaemia, hyperlipidemia and moderate hypertension, which resembles the clinical manifestation of patients with typre-2 diabetes [22]. Therefore, the model is reliable and useful for investigating the underlying mechanisms of vascular dysfunction in typre-2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Experimental Diabetes Mellitus Down-Regulates Large-Conductance Ca2+- Activated K+ Channels in Cerebral Artery Smooth Muscle and Alters Functional Conductance

Wang

Zhang²,

Su³

et al. 2010

CNR

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Cerebral vascular dysfunction and associated vascular complications often develop over time in type-2 diabetes, but the underlying mechanisms are not wholly understood. The aim of the present study was to investigate whether large-conductance Ca(2+)-activated K(+) (BKCa) channels in cerebral artery smooth muscle cells (CASMCs) were impaired in experimental model of type-2 diabetes, and the changes could account for cerebral vascular complication in type-2 diabetes. Sprague-Dawley rats were fed with high fat and glucose diet for 8 weeks and then injected with streptozotocin (STZ/30 mg/kg i.p.). Three months after injection of STZ, the alterations of BKCa channels were assessed by using multi-myograph system, patch-clamp, RT-PCR and Western blot. Our results show that the model is characterized by insulin resistance, hyperglycaemia, hyperlipidemia and moderate hypertension, which resembles the clinical manifestation of patients with typre-2 diabetes. Inhibition of BKCa channels with 1 mM tetraethylammonium (TEA) or 1 microM paxilline (PAX) causes smaller constriction in type-2 diabetic cerebral basilar arteries than control arteries. The contractile efficacy of 5-Hydroxytryptamine (5-HT) is substantially reduced by TEA or PAX pretreatment in control > diabetic basilar artery rings. The response to 5-HT in diabetic basilar artery rings is higher than that of control artery rings after activation of BKCa channels with NS1619. The whole-cell K(+) currents are significantly decreased in type-2 diabetic CASMCs compared to control, and the sensitivity of BKCa channels to voltage, the specific inhibitor and opener are all diminished in diabetic CASMCs. The expression of BKCa channel beta1, but not alpha-subunits is markedly reduced at both of mRNA and protein levels in endothelial-denudated cerebral arteries. In conclusion, type-2 diabetes downregulates BKCa channel beta1-subunits in CASMCs, resulting in reduced activity of BKCa channel, increased vascular tone and blood pressure, thereby contributing to cerebral vascular complication in type-2 diabetes.

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“…Non-insulin dependent diabetes mellitus is characterized by insulin resistance, altered glucose and fatty acid metabolism and moderate hypertension (Ganne et al, 2007;Kashyap and Defronzo, 2007). In many cases, it follows clinically apparent obesity (McGillis Bindler, 2007).…”

Section: Introductionmentioning

confidence: 99%

Myogenic tone and reactivity of cerebral arteries in Type II diabetic BBZDR/Wor rat

Jarajapu

Guberski

Grant

et al. 2008

European Journal of Pharmacology

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BBZDR/Wor rat is a new model of type II diabetes with spontaneous obesity and clinical characteristics close to human diabetes. In this study the time-course of cerebroarterial dysfunction was characterized. Posterior cerebral arteries from BBZDR/Wor rats and their age-matched lean controls were pressurized to 70mmHg in an arteriograph. Effects of intraluminal pressure and different pharmacological agents on myogenic tone were evaluated. Pressure-myogenic tone curves in diabetic arteries were similar to that in non-diabetic arteries at pre-diabetic age, showed leftward shift at 4 weeks and were significantly different with higher myogenic tone at 5 and 8 months of diabetes. Age-dependent decrease in myogenic tone was observed in non-diabetic arteries. Dilation to histamine was similar to that in non-diabetic arteries at pre-diabetic and at 4 weeks but significantly reduced at 5 and 8 months of diabetes. Bradykinin-mediated dilation was significantly reduced in early and chronic diabetes, whereas (±)-S-nitroso-N-acetylpenicillamine (SNAP)-mediated dilation was decreased modestly at 8 months of diabetes. Sensitivity and constriction to 5-hydroxytryptamine were increased in early and chronic diabetes. Responses to bradykinin and 5-hydroxytryptamine were decreased and increased, respectively. Myogenic tone was significantly less sensitive to (lower pIC 50 ) U-73122 than normal arteries at 4 weeks and 8 months of diabetes suggesting an increased activation of phospholipase C (PLC). This study shows that pressure-mediated autoregulation of cerebral arteries in type II diabetes operates at higher resistance. Endothelium-dependent dilation was decreased with chronic diabetes with increased sensitivity to constrictor agonist. Endothelium-independent dilation was modestly affected. Arterial hyper-reactivity to pressure and constrictor agonist were likely due to increased PLC activation.

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Hypertension in people with diabetes and the metabolic syndrome: Pathophysiologic insights and therapeutic update

Cited by 16 publications

References 75 publications

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Experimental Diabetes Mellitus Down-Regulates Large-Conductance Ca2+- Activated K+ Channels in Cerebral Artery Smooth Muscle and Alters Functional Conductance

Myogenic tone and reactivity of cerebral arteries in Type II diabetic BBZDR/Wor rat

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