Hypertension and type 2 diabetes: lights and shadows about causality

Colussi, GianLuca; Porto, Andrea Da; Cavarape, Alessandro

doi:10.1038/s41371-019-0268-x

Cited by 34 publications

(31 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hypertension and DM are two major well-established risk factors for stroke [ 31 ]. The AIS-DM group had a higher percentage of hypertension cases compared to the AIS-NDM group (72.93% versus 63.94%), which corresponded to a previous report in China (which had an incidence of 77.7%) and another report in USA (which had an incidence of 71%) [ 32 , 33 ]. Although it is well known that type 2 DM and hypertension are common comorbidities of AIS, the exact mechanism has not been established.…”

Section: Discussionsupporting

confidence: 87%

Clinical Characteristics and Outcomes of Acute Ischemic Stroke in Patients with Type 2 Diabetes: A Single-Center, Retrospective Study in Southern China

Chen

Luo

et al. 2021

International Journal of Endocrinology

View full text Add to dashboard Cite

Objective. To explore the associations between type 2 diabetes mellitus (DM) and stroke by evaluating the clinical risk factors, characteristics, and outcomes of acute ischemic stroke (AIS) patients with and without type 2 DM. Methods. A total of 1,156 AIS patients (including 410 with type 2 DM (AIS-DM group)) and 746 without type 2 DM (AIS-NDM group)) were included. Patients’ demographics, auxiliary examinations, clinical manifestations, and treatment outcomes were recorded and analyzed. Results. Among the included AIS patients, 35.46% had type 2 DM. The AIS-DM group had less males (59.76% versus 70.64%), less smokers (33.90% versus 41.96%), more patients with hypertension (72.93% versus 63.94%; p = 0.002 ), higher triglyceride levels (42.93% versus 25.08%; p ≤ 0.01 ), and lower total cholesterol (147.06 mg/dl versus 175.31 mg/dl) than the AIS-NDM group. The proportion of patients with large artery atherosclerosis (LAA) in the AIS-DM group was lower (77.56% versus 85.92%; p < 0.05 ) than that in the AIS-NDM group, and the proportion of patients with small arterial occlusions (SAO) in the AIS-DM group was higher (27.07% versus 13.67%; p < 0.05 ) than that in the AIS-NDM group. The mean National Institutes of Health Stroke Scale (NIHSS) score at admission in the AIS-DM group was lower than that in the AIS-NDM group (4.39 versus 5.00; p = 0.008 ), but there was no significant difference in the NIHSS score or the modified Rankin Scale score between the two groups at discharge. A total of 85 AIS patients underwent intravenous thrombolysis treatment with recombinant tissue plasminogen activator (rtPA). The door-to-needle time (DNT) did not differ significantly between the groups (49.39 ± 30.40 min versus 44.25 ± 15.24 min; p = 0.433 ). In addition, there were no significant differences in the baseline NIHSS score, 7-day NIHSS score, and mRS score at discharge between the groups. After intravenous thrombolysis with rtPA, the AIS-NDM group had better recovery (44.30% versus 29.20%; p = 0.017 ) and a higher ratio of good treatment outcome at discharge (65.60% versus 54.20%; p = 0.762 ). Conclusions. Type 2 DM is associated with AIS and its risk factors, such as dyslipidemia and hypertension. Patients in the AIS-DM group had less LAA and smaller arterial occlusions, and DM could exacerbate the short-term clinical outcomes in AIS patients.

show abstract

Section: Discussionsupporting

confidence: 87%

Clinical Characteristics and Outcomes of Acute Ischemic Stroke in Patients with Type 2 Diabetes: A Single-Center, Retrospective Study in Southern China

Chen

Luo

et al. 2021

International Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…Одной из часто встречающихся коморбидностей у пациентов с АГ является сахарный диабет (СД). Так, известно, что около 20% больных с АГ имеют СД, а среди популяции больных с СД сопутствующая АГ встречается в 50-80% случаев [25,26]. К числу органов-мишеней АГ относятся почки, поражение которых при наличии коморбидного СД происходит крайне стремительно [2,3].…”

Section: органопротективные свойстваunclassified

Thiazide and Thiazide-like Diuretics in the Treatment of Arterial Hypertension: are there Any Differences?

Кочетков

2020

Racionalʹnaâ farmakoterapiâ v kardiologii

View full text Add to dashboard Cite

In the current clinical guidelines for arterial hypertension, diuretics are considered one of the first line antihypertensive drugs, which are equivalent in their effectiveness to other main pharmacological classes used in the treatment of this disease. To date, much attention is paid to both the antihypertensive potential of diuretics and their safety profile and ability to influence prognosis. In this regard, a rational approach to the consideration of the clinical and pharmacological properties of these drugs is the isolation of thiazide and thiazide-like drugs among them, which is reflected in international clinical guidelines. Among thiazide-like diuretics, indapamide occupies a special place, favorably distinguished by its antihypertensive properties, metabolic neutrality, as well as the ability to improve the prognosis and favorably influence hard endpoints in the form of mortality rates in patients with hypertension. A unique feature of indapamide is also the presence, in addition to the direct diuretic effect, pleiotropic properties, including, in particular, some antagonism towards calcium and beneficial effects on arteries. This drug has been studied in a large number of studies, including such "difficult" categories of patients as the elderly and patients with diabetes mellitus, where indapamide has proven its powerful target-organ protective potential and metabolic neutrality, distinguishing it among both thiazide-like and thiazide diuretics. Indapamide provides a comprehensive target-organ protection at the level of the heart, blood vessels, kidneys and brain. Based on this, it can be expected that the widespread use of this drug as part of a first-line combination antihypertensive therapy will not only achieve target blood pressure levet in most patients with hypertension, but also provide an improved prognosis and improve the quality and duration of their life.

show abstract

“…За останні 30 років поширеність АГ зменшилась до однієї четвертої частини населення світу [3,4], але захворюваність на ЦД зросла з 4,7 до 8,5 %, і прогноз на майбутнє свідчить про подальший драматичний приріст [5]. Покращення обізнаності, лікування та контролю цих захворювань є основною метою глобальної системи охорони здоров'я [6,7]. Поширеність АГ у хворих на ЦД 2-го типу до трьох разів вища, ніж у пацієнтів без ЦД, а поєднання АГ та ЦД суттєво збільшує ймовірність розвитку серце-во-судинних захворювань (ССЗ) [8,9].…”

unclassified

“…Інсулінорезистентність (ІР), гіперінсулінемія (ГІ), активація оксидантного стресу (ОС) та субклінічне хронічне системне низькоінтенсивне запалення (ХСНЗ) є найбільш вивченими. Зокрема, ГІ індукує ІР і зумовлює розвиток АГ у нормотензивних пацієнтів без ЦД; викликає реконструкцію та ригідність артерій, підвищує активність симпатичної нервової системи, стимулює ренін-ангіотензин-альдостеронову систему та реабсорбцію Na + в нирках [7]. Крім того, надмірний ОС та субклінічне ХСНЗ є визначальними чинниками дисфункції ендотелію, порушень реактивності судин, підвищеної опірності периферичних судин і порушень обміну глюкози та ліпідів.…”

unclassified

See 1 more Smart Citation

Цукровий Діабет І Артеріальна Гіпертензія

Serhiyenko¹,

Serhiyenko²

2021

Mìžnarodnij endokrinologìčnij žurnal

View full text Add to dashboard Cite

This review article summarizes the existing literature on the current state of the problem of diabetes mellitus and arterial hypertension. According to the World Health Organization, hypertension and type 2 diabetes mellitus, after obesity, are among the leading cardiovascular risk factors that are most common among the world’s population. Over the past 30 years, the prevalence of hypertension has decreased to a quarter of the world’s population, but the incidence of diabetes mellitus has increased from 4.7 to 8.5 %, and the forecast for the future indicates a further dramatic increase. Improving awareness, treatment and control of these diseases is a major goal of the global health system. The prevalence of hypertension in patients with type 2 diabetes mellitus is up to three times higher than in patients without diabetes mellitus, and the combination of hypertension and diabetes mellitus significantly increases the likelihood of developing cardiovascular disease. The unfavorable relationship between these two conditions, accelerating the processes of atherosclerosis, can cause negative pathophysiological changes in the cardiovascular system. Also, it is known that cardiovascular autonomic neuropathy, resulting from damage to the autonomic nerve fibers that innervate the heart and blood vessels, is a significant complication of type 2 diabetes mellitus, especially in the presence of systemic hypertension. In particular, the issues related to common pathophysiological mechanisms, main systemic and metabolic factors that may contribute to the development of diabetes mellitus and hypertension comorbidity are analyzed. Classification, features of diagnosis of arterial hypertension, assessment of the disorders of the organs mediated by arterial hypertension are presented. Issues related to the main approaches of arterial hypertension treatment in diabetes mellitus are analyzed, namely prescription of the inhibitors of the renin-angiotensin system, calcium channel blockers, thiazide, and thiazide-like diuretics, beta-adrenergic receptor antagonists, alpha-blockers, mineralocorticoid-receptor antagonists as well as the features of combined therapy and treatment of resistant arterial hypertension.

show abstract

Hypertension and type 2 diabetes: lights and shadows about causality

Cited by 34 publications

References 15 publications

Clinical Characteristics and Outcomes of Acute Ischemic Stroke in Patients with Type 2 Diabetes: A Single-Center, Retrospective Study in Southern China

Clinical Characteristics and Outcomes of Acute Ischemic Stroke in Patients with Type 2 Diabetes: A Single-Center, Retrospective Study in Southern China

Thiazide and Thiazide-like Diuretics in the Treatment of Arterial Hypertension: are there Any Differences?

Цукровий Діабет І Артеріальна Гіпертензія

Contact Info

Product

Resources

About