Metabolic predictors of hypertension

Hypertensive subjects have increased cardiovascular risk factors including dyslipidemia and increased rates of diabetes and hypertension. Insulin resistance is increased in hypertensive subjects, especially lean subjects. Increased insulin resistance in hypertensive subjects may partially mediate the more atherogenic pattern of cardiovascular risk factors in diabetic subjects. Hypertensive subjects are also at increased risk of developing type 2 diabetes possibly by increasing insulin resistance. Hypertensive subjects at particularly high risk of developing type 2 diabetes (i.e. obese or with a family history of type 2 diabetes) should avoid beta-blockers and thiazides, J Hypertens 1999, 17 (suppl 3): S23-S28 (C) 1999 Lippincott Williams & Wilkins.