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Glucose, Insulin and Potential Strategies of Vascular Stiffening

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Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases

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Abstract

Hyperglycemia and hyperinsulinemia which are independent risk factors for vascular stiffening and diabetic vasculopathy are present in most patients with Type 2 diabetes mellitus. In this review we discuss these factors which promote vascular stiffness. We also discuss the roles of renin- angiotensin II -aldosterone (RAAS) activation, obesity, hypertension, dyslipidemia and insulin resistance, features which often present in the CardioRenal metabolic syndrome. Here, we provide new insights in the pathogenesis of vascular stiffening induced by RAAS, including the dysfunction of vascular smooth muscle cells and endothelial cells; inflammation, oxidation stress, as well as alterations in collagen and elastin. We also introduce a novel concept where both β1-integrin and α-smooth muscle actin are likely major players in the increased vascular stiffening as ascertained by atomic force microscopy technology. We explore therapies such as estrogens aimed at vascular de-stiffening which may improve vascular function in patients. This review highlights recent evidence supporting the role of RAAS and insulin resistance in the development of vascular stiffening in diabetic patients.

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Acknowledgements

Studies in the Sowers and Meininger laboratories are supported by NIH grant (NIH P01HL095486) to G.A. Meininger and NIH (R01 HL73101-01A and R01 HL107910-01) and the Veterans Affairs Merit System (0018) for J.R. Sowers. The authors which to thank Brenda Hunter for editing this chapter.

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Authors and Affiliations

  1. Research Service Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65212, USA

    Guanghong Jia PhD & Annayya R. Aroor MD, PhD

  2. Division of Endocrinology and Metabolism, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA

    Guanghong Jia PhD, Annayya R. Aroor MD, PhD & James R. Sowers MD

  3. Dalton Cardiovascular Research Center, University of Missouri School of Medicine, 134 Research Park Drive, Columbia, MO, 65211, USA

    Gerald A. Meininger PhD & James R. Sowers MD

  4. Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, MA415 Medical Sciences Building, One Hospital Drive, Columbia, MO, 65212, USA

    Gerald A. Meininger PhD & James R. Sowers MD

  5. Research Service Harry S Truman Memorial Veterans Hospital, 800 Hospital Dr, Columbia, MO, 65201, USA

    James R. Sowers MD

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  1. Guanghong Jia PhD
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  2. Annayya R. Aroor MD, PhD
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Correspondence to James R. Sowers MD .

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Editors and Affiliations

  1. Hôtel-Dieu Hospital Diagnosis and Therapeutics Center, Paris Descartes University, Paris, Paris, France

    Michel E. Safar

  2. St Vincent Clinic and Hospital, University of New South Wales, Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia

    Michael F. O'Rourke

  3. Department of Cardiology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA

    Edward D. Frohlich

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Jia, G., Aroor, A.R., Meininger, G.A., Sowers, J.R. (2014). Glucose, Insulin and Potential Strategies of Vascular Stiffening. In: Safar, M., O'Rourke, M., Frohlich, E. (eds) Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases. Springer, London. https://doi.org/10.1007/978-1-4471-5198-2_34

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