NOS1 and metabolic syndrome: Metabolic syndrome may be related to the development of hypertension via complex pathways including an increase in angiotensin II via adiposity-induced inflammation and a decrease in NOS activation via oxidative stress and insulin resistance.[37] The two mechanisms are probably intertwined in coexisting hyperuricemia and metabolic syndrome, in which the effect of hyperuricemia on uncontrolled BP might be undetectable, as shown in our study.