IR can cause hyperinsulinemia and dysfunction in endothelial cells, including activation of sodium channels, impaired synthesis of nitric oxide, activation of the renin-angiotensin-aldosterone system, and increased oxidative stress, systemic inflammation and maladaptive immune responses, leading eventually to vascular remodeling, and arterial stiffness (6, 7). The gene discussed is REN; the disease is hyperinsulinism.