Review Article

Hypertension in Metabolic Syndrome: Vascular Pathophysiology

Table 1

Endocrine and vascular paracrine functions of some adipokines.

Adipokine General effectsVascular effectsReferences

LeptinSatiating factor
Physiological regulation of feeding behaviour through hypothalamic receptors
Levels correlate with amount of body fat
Endothelial dysfunction
Endothelium-dependent and independent relaxation
[67, 85, 160165]

ResistinRelates obesity to diabetes by inducing insulin resistanceImpairs endothelial function due to an increase in ET-1 production and a decrease in NO production[166, 167]

AdiponectinLevels inversely correlate with obesityNO-dependent vasorelaxation mediated by channels[91, 93, 94, 168]

VisfatinExpression correlates with obesity degree
Similar effects to insulin in cell culture
NO-dependent vasorelaxation[169171]

TNFαLinks inflammation with obesity
Increase in TNFα expression induces ROS production
Reduces adiponectin production
Endothelium-dependent and -independent vasodilatation
Triggers ET-1 and Ang II-induced vasoconstriction
Impairs endothelium-dependent vasodilatation due to increased ROS production or decreased NO production
Less vasodilatory effect of PAT due to ROS production
[94, 99, 172178]

Interleukin-6Contributes to systemic inflammation and insulin resistanceEndothelium-independent vasodilatation
Endothelial dysfunction due to an increase in ROS production and decreased NO production
[94, 179182]

ProstanoidsSee vascular effects
Hemostasis
Numerous biological functions
Vasoconstriction or vasodilatation depending on which prostanoid[183, 184]

Angiotensin IISee vascular effects
Na+ and water homeostasis
Renal function
Vasoconstriction[185, 186]

Endothelin-1See vascular effectsVasoconstriction[187]

Reactive oxygen speciesNumerous biological effects
Ageing
Vasoconstriction through Ca2+ sensitization
Decrease in NO bioavailability
[73, 188, 189]

Adventitial derived relaxing factorSee vascular effectsVasorelaxation through opening different K+ channels[75, 76, 7880]