Insulin resistance and macrovascular disease

Abstract

Controversy continues as to whether insulin resistance and hyperinsulinemia are risk factors for coronary artery disease. Ethnicity and the presence of other risk factors for atherosclerosis likely govern this relationship, so that the presence of components of the insulin resistance syndrome predispose subjects to coronary artery disease. Insulin itself has effects on the vasculature that may both promote and prevent the atherosclerotic process. An imbalance of these effects, possibly due to insulin resistance in the vasculature, may enhance atherosclerosis.