A growing body of recent evidence suggests, that insulin, in addition to its well-known effects on carbohydrate, protein and lipid metabolism, exerts important actions on endothelial function and vascular tone. This has led to the hypothesis that in states of insulin resistance/hyperinsulinemia, alterations in the vascular actions of insulin may be important in the development and/or reinforcement of hypertension. In this mini-review we discuss (1) the hemodynamic actions of insulin, (2) the direct actions of insulin on vascular tone in states of insulin resistance and hypertension, (3) the interaction of insulin and endothelin-1 and lastly (4) the effects of calcium antagonists on plasma insulin levels and blood pressure. Most of the experiments outlined were conducted in the fructose-induced hypertensive rat model wherein feeding normal Sprague-Dawley rats a 60% fructose diet results in hyperinsulinemia, insulin resistance and elevated blood pressure.
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