Etiology and Prevalence of Hypertension in Diabetic Patients

Abstract

Data from several epidemiologic studies have suggested that the prevalence of hypertension in patients with diabetes mellitus is -1.5-2.0 times greater than in an appropriately matched nondiabetic population. In patients with insulin-dependent diabetes mellitus (IDDM), hypertension is generally not present at the time of diagnosis. As renal insufficiency develops, blood pressure rises and may exacerbate the progression to end-stage renal failure. In non-insulin-dependent diabetes mellitus (NIDDM), many patients are hypertensive at the time of diagnosis. The incidence of hypertension in NIDDM is related to the degree of obesity, advanced age, and extensive atherosclerosis that is typically present, and it probably includes many patients with essential hypertension. Several other pathophysiologic mechanisms also contribute to the genesis and maintenance of hypertension in the patient with diabetes. Hyperglycemia and increases in totalbody exchangeable sodium may lead to extracellular fluid accumulation and expansion of the plasma volume. In some patients, alterations in the function of the renin-angiotensin-aldosterone system and vascular sensitivity to vasoactive hormones may also play a role. It has recently been suggested that hyperinsulinemia and insulin resistance may also contribute to the maintenance of an elevated blood pressure because insulin is known to promote sodium retention and enhance sympathetic nervous system activity. The evidence for these hypotheses and their respective contributions to the etiology of hypertension in IDDM and NIDDM are discussed. Diabetes Care 11:821-27, 1988

Factors Associated With Hypertension Prevalence and Control Among Lebanese Type 2 Diabetic Patients

“…These findings are in alignment with those reported in the literature where age, female gender, obesity and extensive atherosclerosis were reported as risk factors for hypertension development in T2DM patients [22].…”

Vasodilatory Effects of Troglitazone Improve Blood Pressure at Rest and During Mental Stress in Type 2 Diabetes Mellitus

“…Key Words: troglitazone Ⅲ blood pressure Ⅲ vasodilation Ⅲ insulin Ⅲ stress, mental E pidemiological studies have reported that diabetic persons have increased prevalence of hypertension, and the San Antonio Heart Study suggests that 85% of diabetics are hypertensive and obese by the fifth decade of their life. [1][2][3] It is also well documented that diabetic patients are prone to develop microvascular and macrovascular disease and have increased mortality. 4 -7 Although it is not clear how years of poor diabetic control lead to elevated blood pressure (BP), normalizing BP in the diabetic population is particularly important to prevent progression of diabetes mellitus (DM)-related complications.…”

“…[1][2][3] It is also well documented that diabetic patients are prone to develop microvascular and macrovascular disease and have increased mortality. 4 -7 Although it is not clear how years of poor diabetic control lead to elevated blood pressure (BP), normalizing BP in the diabetic population is particularly important to prevent progression of diabetes mellitus (DM)-related complications.…”

Evidence-based approach for managing hypertension in type 2 diabetes

“…6 In the United States, diabetes is also the leading cause of microvascular disorders of end stage renal disease (ESRD) 7,8 and retinopathy. 9 Hypertension is 1.5 to 2.0 times more common in patients with diabetes than without diabetes, 10 and more so in females than males. 11 For example, about 40% of individuals between ages 25 to 65 already have high blood pressure (BP) at the time of diagnosis of diabetes.…”