Relationship Between Insulin Resistance and Cardiovas-cular Risk: An Evidence-Based Review

Abstract

Insulin Resistance (IR) is a metabolic state characterized by a reduced response of target tissues, such as skeletal muscles, liver, and adipose tissue, to the action of insulin, resulting in hyperglycemia and compensatory hyperinsulinemia. This study employed an integrative literature review to understand the underlying mechanisms linking IR to the increased risk of cardiovascular diseases (CVD) and to explore effective intervention strategies to reduce its incidence. Sources were selected from recognized databases, including PubMed, Scielo, and Lilacs, covering publications from 2015 to 2023 and analyzing data on endothelial dysfunction, chronic inflammation, lipid, and hemodynamic alterations. The results indicate that IR is associated with metabolic and hemodynamic changes contributing to the development of CVD, including endothelial dysfunction, vascular inflammation, and increased arterial stiffness. Furthermore, IR promotes an atherogenic lipid profile, hypertension, and reduced vascular elasticity, elevating the risk of cardiovascular complications. Interventions based on lifestyle modifications, such as the Mediterranean diet, physical exercise, and weight control, along with pharmacological agents like metformin and SGLT-2 inhibitors, show potential in reducing cardiovascular risk, although gaps in understanding drug interactions remain. It is concluded that IR is a central factor in the pathogenesis of CVD, underscoring the need for more effective and personalized preventive and therapeutic strategies. Standardized protocols based on robust evidence are essential to improving clinical outcomes. The integration of multidisciplinary approaches and continuous research efforts is crucial to mitigating the impacts of IR and reducing the global burden of CVD, promoting significant advances in the health of at-risk populations.