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Recent work by Stehouwer and his group in Amsterdam has offered some intriguing observations that may even link these three potential explanatory variables. In eighteen healthy subjects with a wide range of insulin sensitivity as measured by euglycaemic clamp, there were close relationships between insulin sensitivity and ambulatory levels of blood pressure. However, when capillary recruitment in a nail bed following arterial occlusion, and endothelial dependent vasodilatation to iontophoresis of acetyl choline were explored, these structural and functional microvascular abnormalities seemed to explain most of the relationship between insulin resistance and blood pressure, suggesting that both hypertension and insulin resistance may have an underlying microvascular aetiology.