Three peer-reviewed studies that establish insulin resistance as a primary cause of hypertension:

All three studies position insulin resistance as a primary causative factor in hypertension rather than merely an association, with detailed mechanistic pathways explaining how insulin resistance induces elevated blood pressure through renal sodium retention, sympathetic nervous system activation, endothelial dysfunction, and vascular inflammation.

Study 1: Insulin Resistance and Hypertension: Mechanisms Involved and Modifying Factors for Effective Glucose Control

Publication: Biomedicines (2023), PMC10452601 

URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC10452601/

Key Conclusion: “IR is a well-known etiology (cause) of primary hypertension in adults” and the stated aim was to “highlight the role of insulin resistance (IR) in inducing hypertension and the detailed mechanism of its pathogenesis.”

This comprehensive review explicitly states that insulin resistance is the main cause of concern in T2DM patients and is associated with hypertension through multiple mechanisms including AGEs, oxidative stress, inflammation, dyslipidemia, endothelial dysfunction and hypervolemia.

Note: AGEs (Advanced Glycation End Products) are harmful compounds formed when proteins or fats combine with sugar molecules in the bloodstream through a process called glycation.

Study 2: The Role Of Insulin Resistance In Hypertension-The Pathophysiological Mechanisms

Publication: The Review of Diabetic Studies (2025) 

URL: https://diabeticstudies.org/index.php/RDS/article/view/829

Key Conclusion: The study found that insulin resistance contributes to hypertension through numerous mechanisms, with compensatory hyperinsulinemia linked to hypertension.  The conclusions state that “Available evidence suggests that insulin resistance plays an important role in the pathophysiology of hypertension. Its contribution to the development and progression of hypertension should not be overlooked.”

Study 3: Insulin Resistance Is Cheerfully Hitched with Hypertension

Publication: Life (MDPI, 2022) 

URL: https://www.mdpi.com/2075-1729/12/4/564

Key Conclusion: Insulin resistance has been proposed to be the underlying cause linking hypertension and diabetes, with patients with high blood pressure showing insulin resistance and having a higher risk of developing diabetes than normotensive individuals.  The study states that hypertension and insulin resistance are strongly related to an increased risk of impaired glucose tolerance, diabetes, and cardiovascular diseases