Diabetes and hypertension: a review.

The basic mechanisms that initiate and sustain hypertension in type 2 diabetics are poorly understood. Contributing factors discussed in this review include obesity, insulin resistance, hyperinsulinemia, genetic factors, and abnormalities of cellular cation homeostasis. Also discussed are the features of hypertension in type 2 diabetic individuals that are reminiscent of the hemodynamic abnormalities characterizing hypertension in the elderly, including increased vascular reactivity and increased atherosclerotic vascular disease. This article reviews mechanisms by which hyperinsulinemia, insulin resistance, or both may lead to hypertension.