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In an ( ex vivo ) hypertrophy model, hearts from ANG-II-treated mice exhibited decreased insulin sensitivity with markedly reduced glucose oxidation rates (Mori et al., 2013), whereas clinical trials in healthy subjects using the hyperinsulinemic euglycemic clamp technique showed that acute and chronic hyperinsulinemia increases RAAS activation (Rooney et al., 1991

These include increasing heart rate and forcing the heart to work harder to pump blood throughout the body, as well as causing atherosclerosis and inflammation in the walls of the blood vessels

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10.1371/journal.ppat.1006687 PLoS Pathog

Financial incentives for smoking cessation in hospitalized patients: a randomized clinical trial