Hyperinsulinemia, sex, and risk of atherosclerotic cardiovascular disease.

Abstract

Therefore, hyperinsulinemia was associated with excess CVD risk in men but not in women, and all excess CVD risk in men was confined to hyperinsulinemic individuals in the presence of glucose intolerance, obesity, or hypertension.

Effect of an angiotensin II receptor antagonist, candesartan, on insulin resistance and pressor mechanisms in essential hypertension

“…Resistance to insulin-mediated glucose uptake and the resulting hyperinsulinaemia may possibly contribute to the pathogenesis of these disorders. It has also been recently suggested that insulin resistance and hyperinsulinaemia may be associated with hypertensive arteriosclerotic complications, including coronary artery disease, [1][2][3][4] and that metabolic side effects should be considered when selecting antihypertensive agents. 19,20 These results suggest that angiotensin II antagonists could be useful antihypertensive drugs in essential hypertension patients with insulin resistance.…”

“…[1][2][3][4] Several kinds of hypotensive drugs, such as thiazide diuretics and ␤-blockers, have been reported to impair insulin sensitivity. 5,6 Conversely, it has been recognised that angiotensinconverting enzyme (ACE) inhibition improves insulin sensitivity in essential hypertension, [5][6][7][8] suggesting an important role for the suppression of angiotensin II generation.…”

Are gender differences in cardiovascular disease risk factors explained by the level of visceral adipose tissue?

“…Many studies have demonstrated that men and women generally display marked differences in regional fat distribution [4,34,35], lipoprotein profile [37] and indices of plasma glucose-insulin homeostasis [12,38,39]. Our results agree with these previous reports, as our sample of men had higher levels of abdominal adipose tissue, lower plasma HDL-chol concentrations, higher plasma TG levels, and higher plasma insulin and glucose areas measured during the oral glucose tolerance test in comparison with women, after adjustment for differences in body fat mass.…”

Relationships between abdominal body fat distribution and cardiovascular risk factors: an explanation for women’s healthier cardiovascular risk profile. The D.E.S.I.R. Study

“…48,49 As a consequence, putting forward a gender-speci®c susceptibility to high levels of insulin, some authors suggest that hyperinsulinaemia, as a marker of insulin resistance, is responsible for the discrepancy in CVD rates between men and women. 49 However this hypothesis Abdominal body fat distribution and cardiovascular risk factors S Bertrais et al is not supported by the increased cardiovascular risk in women with impaired glucose tolerance, 50 nor the lost relative protection in diabetic women. 13 In addition, the independent predictive power of fasting insulin has not been reported in all studies of men.…”