{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:53:23Z","timestamp":1787018003517,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2001,9]]},"abstract":"<jats:p>\n                    <jats:italic>\n                      <jats:italic>Abstract<\/jats:italic>\n                      \u2014\n                    <\/jats:italic>\n                    \u2014 Obesity has been shown to be an independent risk factor for coronary heart disease. The insulin resistance associated with obesity contributes to the development of other cardiovascular risk factors, including dyslipidemia, hypertension, and type 2 diabetes. The coexistence of hypertension and diabetes increases the risk for macrovascular and microvascular complications, thus predisposing patients to cardiac death, congestive heart failure, coronary heart disease, cerebral and peripheral vascular diseases, nephropathy, and retinopathy. Body weight reduction increases insulin sensitivity and improves both blood glucose and blood pressure control. Metformin therapy also improves insulin sensitivity and has been associated with decreases in cardiovascular events in obese diabetic patients. Antihypertensive treatment in diabetics decreases cardiovascular mortality and slows the decline in glomerular function. However, pharmacological treatment should take into account the effects of the antihypertensive agents on insulin sensitivity and lipid profile. Diuretics and \u03b2-blockers are reported to reduce insulin sensitivity and increase triglyceride levels, whereas calcium channel blockers are metabolically neutral and ACE inhibitors increase insulin sensitivity. For the high-risk hypertensive diabetic patients, ACE inhibition has proven to confer additional renal and vascular protection. Because hypertension and glycemic control are very important determinants of cardiovascular outcome in obese diabetic hypertensive patients, weight reduction, physical exercise, and a combination of antihypertensive and insulin sensitizers agents are strongly recommended to achieve target blood pressure and glucose levels.\n                  <\/jats:p>","DOI":"10.1161\/01.hyp.38.3.705","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:25:31Z","timestamp":1339446331000},"page":"705-708","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":92,"title":["Treatment of Obesity Hypertension and Diabetes Syndrome"],"prefix":"10.1161","volume":"38","author":[{"given":"Maria Teresa","family":"Zanella","sequence":"first","affiliation":[{"name":"From the Nephrology and Endocrinology Divisions, Hospital do Rim e Hipertensa\u0303o, Federal University of Sa\u0303o Paulo, Sa\u0303o Paulo, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Osvaldo","family":"Kohlmann","sequence":"additional","affiliation":[{"name":"From the Nephrology and Endocrinology Divisions, Hospital do Rim e Hipertensa\u0303o, Federal University of Sa\u0303o Paulo, Sa\u0303o Paulo, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artur Beltrame","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"From the Nephrology and Endocrinology Divisions, Hospital do Rim e Hipertensa\u0303o, Federal University of Sa\u0303o Paulo, Sa\u0303o Paulo, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.19.5.403"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(93)90447-H"},{"key":"e_1_3_1_3_2","first-page":"559","volume":"10","year":"1992","unstructured":"Zanella MT, Freire MBS, Milagres R, Ferreira S, Bonomo PP, Kohlmann O Jr, Ribeiro AB. Blood pressure disturbances in diabetes mellitus. J Hypertension. . 1992; 10: 559\u2013570.","journal-title":"J Hypertension"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-122-7-199504010-00001"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-128-2-199801150-00001"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.14.3.173"},{"key":"e_1_3_1_7_2","doi-asserted-by":"crossref","first-page":"I-161","DOI":"10.1161\/01.HYP.19.2.161","volume":"19","year":"1992","unstructured":"Landsberg L. Hyperinsulinemia: possible role in obesity-induced hypertension. Hypertension. . 1992; 19 (suppl I): I-161\u2013I-166.","journal-title":"Hypertension"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1993.224"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.23.3.381"},{"key":"e_1_3_1_10_2","first-page":"11","volume":"4","year":"1985","unstructured":"Borch-Johnson K, Nissen R, Nerup J. Blood pressure after 40 years of insulin-dependent diabetes. Nephron. . 1985; 4: 11\u201312.","journal-title":"Nephron"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7160.693"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.23.2.145"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.16.10.1387"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI118041"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)07019-6"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)07037-8"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)04311-6"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7160.703"},{"key":"e_1_3_1_19_2","first-page":"1356","volume":"329","year":"1993","unstructured":"Lewis EJ, Hunsicker LG, Bain RP, Rohde RD, for the Collaborative Study Group. The effect of angiotensin converting enzyme inhibition on diabetic nephropathy. N Engl J Med. . 1993; 329: 1356\u20131462.","journal-title":"N Engl J Med"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/7.10.119S"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1992.443"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/6.5.337"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/hyp.25.5.1003"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001203420301"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)12323-7"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1985.234"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.3317\/jraas.2000.062"},{"key":"e_1_3_1_28_2","first-page":"II-26","volume":"19","year":"1992","unstructured":"Zanella MT, Plavnik FL, Kohlmann O Jr. Ribeiro AB. Hypokalemia, glucose intolerance and hyperinsulinemia during diuretic therapy. Hypertension. . 1992; 19 (supp II): II-26\u2013II-29.","journal-title":"Hypertension"},{"key":"e_1_3_1_29_2","first-page":"47","volume":"67","year":"1996","unstructured":"Zanella MT, Baptista M, Costa CH, Kohlmann NE, Kohlmann O, Junior Ribeiro AB. Comparative effects of captopril and chlorthalidone on glucose tolerance and insulin levels in essential hypertensives. Arq Bras Cardiol. . 1996; 67: 47\u201352.","journal-title":"Arq Bras Cardiol"},{"key":"e_1_3_1_30_2","first-page":"919","volume":"81","year":"1991","unstructured":"Passmore AP, Whitehead EM, Crawford V, McVeigh GE, Johnston GD. The antihypertensive and metabolic effects of low and conventional dose cyclopenthiazide in type II diabetics with hypertension. Q J Med. . 1991; 81: 919\u2013928.","journal-title":"Q J Med"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540230036032"},{"key":"e_1_3_1_32_2","first-page":"289","volume":"8","year":"1996","unstructured":"Cadaval RAM, Plavnik FL, Kohlmann NE, Kohlmann O Jr, Ribeiro AB, Zanella MT. An open comparative study of the effects of amlodipine and propranolol on insulin sensitivity in hypertensive patients with android obesity. Eur J Clin Res. . 1996; 8: 289\u2013298.","journal-title":"Eur J Clin Res"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7160.713"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199903043400902"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.4.597"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199803053381003"}],"container-title":["Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.HYP.38.3.705","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T14:28:34Z","timestamp":1715524114000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.HYP.38.3.705"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,9]]},"references-count":36,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2001,9]]}},"alternative-id":["10.1161\/01.HYP.38.3.705"],"URL":"https:\/\/doi.org\/10.1161\/01.hyp.38.3.705","relation":{},"ISSN":["0194-911X","1524-4563"],"issn-type":[{"value":"0194-911X","type":"print"},{"value":"1524-4563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,9]]},"assertion":[{"value":"2001-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-05-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-09-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}