González CA, Alexanderson G, Camacho J, Quiñónez S, Mauricio SP, Hernández-Y-H H, Luengas-E ME

Idioma: Español
Referencias bibliográficas: 74
Paginas: 314-322
Archivo PDF: 114.22 Kb.

RESUMEN

La resistencia a la insulina y su resultante la hiperinsulinemia, son factores que a través de diversos mecanismos, favorecen entre otras alteraciones a la hipertensión arterial y a la aterosclerosis. Participan factores genéticos que al coexistir con estímulos ambientales permiten su expresión y la manifestación de la enfermedad. Los mecanismos participantes entre otros, son la retención renal de sodio, el estímulo de la actividad de la bomba Na+ -H+, la disminución de la actividad de la Na+-K+ ATPasa dependiente de calcio, el aumento de la expresión del gene de la endotelina 1, el aumento en la síntesis del factor de crecimiento semejante a la insulina 1, la activación del sistema nervioso simpático y el crecimiento y proliferación de las células del músculo liso vascular. En todo hipertenso, se deberá considerar la posibilidad de que la resistencia a la insulina esté involucrada en la génesis de la enfermedad y tener un amplio conocimiento de los fármacos antihipertensivos para seleccionar el más conveniente, entre los que destacan los inhibidores de la enzima convertidora de angiotensina, los bloqueadores de los receptores AT1 y los calcioantagonistas.

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