Hyperinsulinemia of insulin resistance occurs because of a lack of vasodilatory and anti-inflammatory effects of insulin. It is not the insulin itself, but the loss of its anti-inflammatory effects due to insulin resistance that is the culprit in atherosclerosis of diabetes.1
Tseng2 states that the benefit of lowering blood glucose levels with exogenous insulin may be counteracted by the potential risk for insulin-induced atherosclerosis. Tseng2 frequently reiterates the atherogenic effects of insulin as if it were a proven fact. I find that the conclusion of this study, that insulin users are at higher risk for development of hypertension, is a speculation based on a flawed premise.
Mirza SA. It Is Time We Ended the Myth of Insulin as an Atherogenic Hormone. Arch Intern Med. 2007;167(8):858-859. doi:10.1001/archinte.167.8.858