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[原发性高血压与糖尿病]

[Essential hypertension and diabetes mellitus].

作者信息

Dietze G, Wicklmayr M, Rett K, Mehnert H

机构信息

Medizinische Fachklinik Bühlerhöhe, Bühl.

出版信息

Fortschr Med. 1990 Feb 28;108(6):103-6.

PMID:2182485
Abstract

While the incidence of essential hypertension is not increased in type 1 diabetics, it is about three times as high in type 2 diabetics. Since in 50% of the cases, hypertension is present before the metabolic disorder becomes manifest, an association between the etiologies of the two disturbances was suspected as long as 65 years ago. A new understanding of the significance of insulin resistance and hyperinsulinemia suggests that the two conditions are part of a single metabolic disorder. This is supported by the fact that normal-weight hypertensives can also manifest insulin resistance, and they more often develop a type 2 diabetes mellitus. These facts urge us to re-think our therapeutic approach to hypertension, and to employ, as far as possible, only those substances that have no negative influence on the incidence of the metabolic disorder. With the introduction of ACE-inhibitors capable of improving insulin sensitivity, we now have, for the first time, the possibility of improving the prognosis of the metabolic syndrome. Moreover, their molecular mechanism of action provides initial clues as to the possible etiology of the syndrome.

摘要

虽然1型糖尿病患者原发性高血压的发病率并未增加,但2型糖尿病患者的发病率约为前者的三倍。由于在50%的病例中,高血压在代谢紊乱显现之前就已存在,早在65年前人们就怀疑这两种紊乱的病因之间存在关联。对胰岛素抵抗和高胰岛素血症重要性的新认识表明,这两种情况是单一代谢紊乱的一部分。体重正常的高血压患者也会出现胰岛素抵抗,并且他们更常发展为2型糖尿病,这一事实支持了上述观点。这些事实促使我们重新思考高血压的治疗方法,并尽可能只使用那些对代谢紊乱发病率没有负面影响的药物。随着能够提高胰岛素敏感性的ACE抑制剂的引入,我们现在首次有可能改善代谢综合征的预后。此外,它们的分子作用机制为该综合征可能的病因提供了初步线索。

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