Insulin resistance and glomerular hemodynamics in essential hypertension

Andronico, Giuseppe; Ferraro-Mortellaro, R.; Mangano, M T; Rome, M Noël; Raspanti, Francesco Giuseppe; Pinto, Antonio; Licata, Giuseppe; Seddio, Giovanna; Mulè, Giuseppe; Cerasola, Giovanni

doi:10.1046/j.1523-1755.2002.00529.x

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…The pathology of the kidney in hypertension has also changed, showing that in recent times segmental glomerulosclerosis appears to be the key lesion in hypertensive nephrosclerosis 37 . This fact suggests that the metabolic syndrome is more important than hypertension in renal failure attributed to hypertensive nephrosclerosis 38 …”

Section: Ras Blockade In Hypertensive Nephrosclerosismentioning

confidence: 99%

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Prescribing angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers in chronic kidney disease (Review Article)

Ferrari

2007

Nephrology

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SUMMARY:In Australia the number of patients developing end-stage kidney disease is growing. Almost 70% of new cases of treated end-stage kidney disease are due to diabetes, hypertension or glomerulonephritis. The majority of these patients have a chronic decline of renal function over many years before dialysis is required, even when the initial insult is no longer present. Hypertension and the degree of proteinuria are the most important determinants for this progression and ample evidence suggests that angiotensin II is the key player in sustaining both hypertension and proteinuria. Angiotensin II mediates not only haemodynamic changes but also profibrotic and pro-inflammatory processes. Blockade of the renin-angiotensin system decreases proteinuria and slows the progression of both diabetic and non-diabetic proteinuric renal disease. Angiotensin-converting enzyme (ACE) inhibitors are first-line therapy in patients with type 1 diabetes mellitus and nephropathy, whereas angiotensin receptor blockers (ARB) are first-line therapy in patients with type 2 diabetes mellitus and microalbuminuria or overt nephropathy. Finally, treatment with ACE inhibitors delays the progression of proteinuric nephropathy in nondiabetic patients. Combination therapy with ACE inhibitors and ARB may allow a more complete blockade of the renin-angiotensin system and clinical trials show that ACE inhibitor-ARB combinations have an additive antiproteinuric effect of up to 40% compared with ACE inhibitor or ARB alone, without additional blood pressure-lowering effect. Finally, it is important to emphasize that progressive lowering of blood pressure to 120 mmHg is associated with improved renal outcome and that this effect is independent of baseline renal function.

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Section: Ras Blockade In Hypertensive Nephrosclerosismentioning

confidence: 99%

“…37 This fact suggests that the metabolic syndrome is more important than hypertension in renal failure attributed to hypertensive nephrosclerosis. 38…”

Section: Ras Blockade In Hypertensive Nephrosclerosismentioning

confidence: 99%

Prescribing angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers in chronic kidney disease (Review Article)

Ferrari

2007

Nephrology

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“…Furthermore, many studies have reported that hyperinsulinemia and insulin resistance may contribute to both LV diastolic dysfunction (37)(38)(39) and glomerular hyperten- , diastolic-to-systolic ratio; RI, resistance index; A/E, peak velocity ratio of the atrial filling wave-to-early diastolic filling wave; DcT, deceleration time of the E wave; GT, glucose tolerance. sion and hyperfiltration (40)(41)(42). This abundance of glucose tolerance-related factors that modify LV diastolic function and renal Doppler parameters might have extinguished the relation between these two Doppler parameters in patients with glucose intolerance.…”

Section: Fig 1 Correlation Between Renal Doppler Parameters (D/s Anmentioning

confidence: 99%

Association between Left Ventricular Diastolic Dysfunction and Renal Hemodynamic Change in Patients with Treated Essential Hypertension

et al. 2003

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The heart and kidneys are important target organs in hypertension. Early signs of hypertensive target organ Abnormalities in left ventricular (LV) diastolic filling have been described in patients with hypertension, even in the absence of left ventricular hypertrophy (7-9). Moreover, impaired LV diastolic relaxation is a prognostic indicator of cardiovascular risk (10). An increased intrarenal resistance index (RI) evaluated by renal Doppler ultrasonography has also been reported in patients with essential hypertension (11,12). Assessment of intrarenal vascular resistance is useful in determining the degree of intrarenal damage. High levels of RI are associated with subclinical end-organ damage-namely microalbuminuria, LV hypertrophy, and carotid atherosclerosis-in hypertensive patients (13,14). In addition, an RI value of ≥ 0.8 is a strong and independent

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“…The mechanism of reducing insulin secretion occurs as a result of two phenomena: a reduction in the β-cell mass and their abnormal function. Autopsies of deceased diabetic patients, as well as animal model studies have demonstrated a decrease in the size of β cells by 30-50% and the presence of amyloid plaques (Andronico et al, 2002;Bhanot & McNeill, 1996;Kahn, 2003).…”

Section: Insulin Resistance and Changes In The β Cell Functionmentioning

confidence: 99%

Changes in the pancreas caused by different types of hypertension

Nowińska

2017

Acta Biochim Pol

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Hypertension is considered a lifestyle disease. Unfavorable forecasts predict a significant increase in the number of patients suffering from this disorder. Many changes in various organs have been observed as a result of ischemia. An interesting question arises of whether differences between the mechanisms occurring in different types of hypertension could produce different effects in the organs. It is well known that there is a close relationship between hypertension and insulin resistance. On the other hand, insulin resistance is the main cause of type 2 diabetes, which develops in parallel with changes in the pancreas. The pancreas is a very important organ since it produces enzymes crucial for the digestive process, as well as performs an important endocrine function. The work presented here focuses primarily on the latter issue. The authors present an overview of contemporary literature concerning the influence of different types of hypertension on the function of the pancreas.

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Insulin resistance and glomerular hemodynamics in essential hypertension

Abstract: The progressive decrease of glomerular function in subjects with hypertension is linked with insulin-resistance.

Cited by 14 publications

References 24 publications

Prescribing angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers in chronic kidney disease (Review Article)

Prescribing angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers in chronic kidney disease (Review Article)

Association between Left Ventricular Diastolic Dysfunction and Renal Hemodynamic Change in Patients with Treated Essential Hypertension

Changes in the pancreas caused by different types of hypertension

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