Florkowski C M, Harrison J, Kendall M J
Queen Elizabeth Hospital, Birmingham, U.K.
J Clin Pharm Ther. 1992 Jun;17(3):147-54. doi: 10.1111/j.1365-2710.1992.tb01284.x.
Coronary artery disease is a very common disorder for which hypertension is a well-recognized risk factor. However many trials of antihypertensive therapy have failed to demonstrate a reduction in the incidence of coronary events. One explanation is that hypertension is a disorder associated with hyperinsulinaemia, obesity and non-insulin dependent diabetes. Furthermore certain antihypertensive drugs, notably thiazide diuretics, increase the hyperinsulinaemia and thereby increase one of the other coronary risk factors. In this review the links between hypertension and hyperinsulinaemia are explored and the mechanisms whereby an increased plasma insulin can lead to the more rapid development of coronary artery disease are explained. These observations may influence the choice of drugs used to treat hypertension.
冠状动脉疾病是一种非常常见的病症，而高血压是一个公认的危险因素。然而，许多抗高血压治疗试验未能证明冠状动脉事件的发生率有所降低。一种解释是，高血压是一种与高胰岛素血症、肥胖和非胰岛素依赖型糖尿病相关的病症。此外，某些抗高血压药物，特别是噻嗪类利尿剂，会增加高胰岛素血症，从而增加其他冠状动脉危险因素之一。在这篇综述中，探讨了高血压与高胰岛素血症之间的联系，并解释了血浆胰岛素升高可导致冠状动脉疾病更快发展的机制。这些观察结果可能会影响用于治疗高血压的药物选择。
