Abstract
Hypertension, glucose intolerance, obesity, and hyperlipidemia are extremely prevalent problems in Western society, and each confers increased risk for coronary heart disease (CHD; Donahue, Skyler, Schneiderman, & Prineas, 1990). This cluster of disorders is so commonly associated as to suggest common pathogenetic mechanisms. Hyperinsulinemia and insulin resistance have been proposed to be the underlying link between these disorders (Christlieb, Krolewski, Warram, & Soeldner, 1985; Donahue et al., 1990; Ferrari & Weidmann, 1990; Krieger & Landsberg, 1988; Reaven & Hoffman, 1987; Sims, 1982; Swislocki, 1990), which collectively have been dubbed the GOH (glucose intolerance–obesity–hypertension) syndrome by Modan et al. (1985), "Syndrome X" by Reaven (1988), the "deadly quartet" by Kaplan (1989), the "chronic disease risk factor syndrome" by Zimmet (1989), and the "insulin resistance syndrome" by DeFronzo and Ferrannini (1990).