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Most of the deleterious actions of the RAAS on insulin sensitivity appear to be mediated through activation of the Angiotensin II (Ang II) Receptor type 1 (AT<jats:sub>1<\/jats:sub>R) and increased production of mineralocorticoids. The underlying mechanisms leading to impaired insulin sensitivity remain to be fully elucidated, but involve increased production of reactive oxygen species and oxidative stress. Both experimental and clinical studies also implicate aldosterone in the development of insulin resistance, hypertension, endothelial dysfunction, cardiovascular tissue fibrosis, remodelling, inflammation and oxidative stress. There is abundant evidence linking aldosterone, through non\u2010genomic actions, to defective intracellular insulin signalling, impaired glucose homeostasis and systemic insulin resistance not only in skeletal muscle and liver but also in cardiovascular tissue. Blockade of the different components of the RAAS, in particular Ang II and AT<jats:sub>1<\/jats:sub>R, results in attenuation of insulin resistance, glucose homeostasis, as well as decreased cardiovascular disease morbidity and mortality. These beneficial effects go beyond to those expected with isolated control of hypertension. This review focuses on the role of Ang II and aldosterone in the pathogenesis of insulin resistance, as well as in clinical relevance of RAAS blockade in the prevention and treatment of the metabolic syndrome and cardiovascular disease.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2008.03498.x","type":"journal-article","created":{"date-parts":[[2008,12,5]],"date-time":"2008-12-05T10:32:24Z","timestamp":1228473144000},"page":"1-6","source":"Crossref","is-referenced-by-count":73,"title":["Role of aldosterone and angiotensin II in insulin resistance: an update"],"prefix":"10.1111","volume":"71","author":[{"given":"Guido","family":"Lastra\u2010Lastra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Sowers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Restrepo\u2010Erazo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Manrique\u2010Acevedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Lastra\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,6,10]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-006-0036-5"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI111776"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199604113341504"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030207"},{"key":"e_1_2_3_6_2","first-page":"893","article-title":"Mineralocorticoid excess, dietary sodium, and myocardial fibrosis","volume":"120","author":"Brilla C.G.","year":"1992","journal-title":"Journal of Laboratory and Clinical Medicine"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2005.02.003"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.2007.S5"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.49.11.1751"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000231552.10054.aa"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2007.03.012"},{"key":"e_1_2_3_12_2","first-page":"755","article-title":"Does insulin resistance participate in an impaired glucose tolerance in primary aldosteronism?","volume":"8","author":"Shimamoto K.","year":"1994","journal-title":"Journal of Human Hypertension"},{"key":"e_1_2_3_13_2","first-page":"21","article-title":"Insulin action in primary hyperaldosteronism before and after surgical or pharmacological treatment","volume":"108","author":"Sindelka G.","year":"2000","journal-title":"Experimental and Clinical Endocrinology and Diabetes"},{"key":"e_1_2_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0024-3205(92)90062-T"},{"key":"e_1_2_3_15_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.2001.281.4.R1041"},{"key":"e_1_2_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0960-0760(99)00117-X"},{"key":"e_1_2_3_17_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0736"},{"key":"e_1_2_3_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/5.1.26"},{"key":"e_1_2_3_19_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1733"},{"key":"e_1_2_3_20_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0251"},{"key":"e_1_2_3_21_2","doi-asserted-by":"publisher","DOI":"10.1096\/fj.07-9412com"},{"key":"e_1_2_3_22_2","doi-asserted-by":"publisher","DOI":"10.1096\/fj.06-7970com"},{"key":"e_1_2_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0303-7207(94)90027-2"},{"key":"e_1_2_3_24_2","doi-asserted-by":"crossref","first-page":"E719","DOI":"10.1152\/ajpendo.1991.260.5.E719","article-title":"Rapid effects of mineralocorticoids on sodium\u2010proton exchanger: genomic or nongenomic pathway?","volume":"260","author":"Wehling M.","year":"1991","journal-title":"American Journal of Physiology. 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