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Hypertension in Metabolic Syndrome: Vascular Pathophysiology

Metabolic syndrome is a cluster of metabolic and cardiovascular symptoms: insulin resistance (IR), obesity, dyslipemia. Hypertension and vascular disorders are central to this syndrome. After a brief historical review, we discuss the role of sympathetic tone. Subsequently, we examine the link betwee...

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Autores principales: Mendizábal, Yolanda, Llorens, Silvia, Nava, Eduardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615624/
https://www.ncbi.nlm.nih.gov/pubmed/23573411
http://dx.doi.org/10.1155/2013/230868
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author Mendizábal, Yolanda
Llorens, Silvia
Nava, Eduardo
author_facet Mendizábal, Yolanda
Llorens, Silvia
Nava, Eduardo
author_sort Mendizábal, Yolanda
collection PubMed
description Metabolic syndrome is a cluster of metabolic and cardiovascular symptoms: insulin resistance (IR), obesity, dyslipemia. Hypertension and vascular disorders are central to this syndrome. After a brief historical review, we discuss the role of sympathetic tone. Subsequently, we examine the link between endothelial dysfunction and IR. NO is involved in the insulin-elicited capillary vasodilatation. The insulin-signaling pathways causing NO release are different to the classical. There is a vasodilatory pathway with activation of NO synthase through Akt, and a vasoconstrictor pathway that involves the release of endothelin-1 via MAPK. IR is associated with an imbalance between both pathways in favour of the vasoconstrictor one. We also consider the link between hypertension and IR: the insulin hypothesis of hypertension. Next we discuss the importance of perivascular adipose tissue and the role of adipokines that possess vasoactive properties. Finally, animal models used in the study of vascular function of metabolic syndrome are reviewed. In particular, the Zucker fatty rat and the spontaneously hypertensive obese rat (SHROB). This one suffers macro- and microvascular malfunction due to a failure in the NO system and an abnormally high release of vasoconstrictor prostaglandins, all this alleviated with glitazones used for metabolic syndrome therapy.
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spelling pubmed-36156242013-04-09 Hypertension in Metabolic Syndrome: Vascular Pathophysiology Mendizábal, Yolanda Llorens, Silvia Nava, Eduardo Int J Hypertens Review Article Metabolic syndrome is a cluster of metabolic and cardiovascular symptoms: insulin resistance (IR), obesity, dyslipemia. Hypertension and vascular disorders are central to this syndrome. After a brief historical review, we discuss the role of sympathetic tone. Subsequently, we examine the link between endothelial dysfunction and IR. NO is involved in the insulin-elicited capillary vasodilatation. The insulin-signaling pathways causing NO release are different to the classical. There is a vasodilatory pathway with activation of NO synthase through Akt, and a vasoconstrictor pathway that involves the release of endothelin-1 via MAPK. IR is associated with an imbalance between both pathways in favour of the vasoconstrictor one. We also consider the link between hypertension and IR: the insulin hypothesis of hypertension. Next we discuss the importance of perivascular adipose tissue and the role of adipokines that possess vasoactive properties. Finally, animal models used in the study of vascular function of metabolic syndrome are reviewed. In particular, the Zucker fatty rat and the spontaneously hypertensive obese rat (SHROB). This one suffers macro- and microvascular malfunction due to a failure in the NO system and an abnormally high release of vasoconstrictor prostaglandins, all this alleviated with glitazones used for metabolic syndrome therapy. Hindawi Publishing Corporation 2013 2013-03-20 /pmc/articles/PMC3615624/ /pubmed/23573411 http://dx.doi.org/10.1155/2013/230868 Text en Copyright © 2013 Yolanda Mendizábal et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Mendizábal, Yolanda
Llorens, Silvia
Nava, Eduardo
Hypertension in Metabolic Syndrome: Vascular Pathophysiology
title Hypertension in Metabolic Syndrome: Vascular Pathophysiology
title_full Hypertension in Metabolic Syndrome: Vascular Pathophysiology
title_fullStr Hypertension in Metabolic Syndrome: Vascular Pathophysiology
title_full_unstemmed Hypertension in Metabolic Syndrome: Vascular Pathophysiology
title_short Hypertension in Metabolic Syndrome: Vascular Pathophysiology
title_sort hypertension in metabolic syndrome: vascular pathophysiology
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615624/
https://www.ncbi.nlm.nih.gov/pubmed/23573411
http://dx.doi.org/10.1155/2013/230868
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