[Insulin resistance and renin-angiotensin-aldosterone system].

Insulin resistance up-regulates the renin-angiotensin-aldosterone system (RAA system) by various mechanisms, which contributes to the pathogenesis of hypertension and atherosclerosis. On the other hand, RAA system activates the insulin resistance by angiotensin II (Ang II) blocking effects of the intracellular signal transduction system of insulin, by oxidative stress and by reduction of adiponectin level, which effects are induced by Ang II. Ang II receptor blockers indicate that the use of these agents results in fewer cases of new-onset diabetes among patients with hypertension, when compared with other antihypertensive agents. Ang II has direct and indirect effects on insulin resistance/hyperinsulinemia, providing support for the biologic mechanism underlying the benefits of RAA system inhibition in preventing cardiovascular events.