| Hypertension management and microvascular insulin resistance in diabetes. | |
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MedLine Citation:
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PMID: 20582734 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Type 2 diabetes is in essence a vascular disease and is frequently associated with hypertension, macrovascular events, and microvascular complications. Microvascular dysfunction, including impaired recruitment and capillary rarefaction, has been implicated in the pathogenesis of diabetic complications. Microvascular insulin resistance and renin-angiotensin system upregulation are present in diabetes, and each contributes to the development of hypertension and microvascular dysfunction. In the insulin-sensitive state, insulin increases microvascular perfusion by increasing endothelial nitric oxide production, but this effect is abolished by insulin resistance. Angiotensin II, acting via the type 1 receptors, induces inflammation and oxidative stress, leading to impaired insulin signaling, reduced nitric oxide availability, and vasoconstriction. Conversely, it acts on the type 2 receptors to cause vasodilatation. Because substrate and hormonal exchanges occur in the microvasculature, antihypertensive agents targeted to improve microvascular insulin sensitivity and function may have beneficial effects beyond their capacity to lower blood pressure in patients with diabetes. |
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Authors:
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Seung-Hyun Ko; Wenhong Cao; Zhenqi Liu |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Current hypertension reports Volume: 12 ISSN: 1534-3111 ISO Abbreviation: Curr. Hypertens. Rep. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-28 Completed Date: 2011-06-02 Revised Date: 2011-07-20 |
Medline Journal Info:
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Nlm Unique ID: 100888982 Medline TA: Curr Hypertens Rep Country: United States |
Other Details:
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Languages: eng Pagination: 243-51 Citation Subset: IM |
Affiliation:
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Division of Endocrinology & Metabolism, Department of Internal Medicine, University of Virginia Health System, PO Box 801410, Charlottesville, VA 22908-1410, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin II
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antagonists & inhibitors,
drug effects Angiotensin Receptor Antagonists / pharmacology Diabetes Mellitus, Type 2 / drug therapy*, pathology, prevention & control Humans Hypertension / drug therapy* Inflammation / drug therapy, pathology Insulin Resistance* Microcirculation / drug effects* Microvessels / drug effects*, pathology Nitric Oxide Synthase Type III / drug effects, metabolism Oxidative Stress / drug effects Receptor, Angiotensin, Type 1 / drug effects Receptor, Angiotensin, Type 2 / drug effects Renin-Angiotensin System / drug effects Signal Transduction |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL094722-01A2/HL/NHLBI NIH HHS; R01HL094722/HL/NHLBI NIH HHS; RR-00847/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin Receptor Antagonists; 0/Receptor, Angiotensin, Type 1; 0/Receptor, Angiotensin, Type 2; 11128-99-7/Angiotensin II; EC 1.14.13.39/Nitric Oxide Synthase Type III |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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