Review Hypertension, Obesity, Glucose Intolerance, Dyslipidemia and Insulin Resistance

Epidemiological and clinical evidence suggesting an association between hypertension, diabetes mellitus, obesity and dysplipidemia existed for a long time. Recently it was concluded that this assocciation was related with insulin resistance and hyperinsulinemia. It was suggested that the primary defect in hypertension is peripheral insulin resistance. It was also shown that insulin itself is a risk factor for ischemic heart disease. Glucose intolerance and insulin resistance have been described in most of the old hypertensives with upper obesity. Syndrome X consisting of hypertension, upper obesity, glucose intolerance with hyperinsulinemia, and hypertriglyceridemia have been defined and this quartet was called "deadly quartet". Keeping in mind a possible insulin resistance in the therapy of obese hypertensives with coronary heart disease is important in attempting to reduce the cardiovascular risk.