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Hypertension and diabetes in women
Gastone Leonetti1, Laura Lonati, Cesare Cuspidi
1St Luca Hospital, IRCCS, Istituto Auxologico Italiano, Istituto di Clinica Medica Generale, University of Milano, Milan, Italy. gastone.leonetti.@unimi.it
Insights
Arterial hypertension and diabetes mellitus are significant cardiovascular risk factors, especially when co-occurring in women. Their combined presence during pregnancy poses risks to both mother and fetus.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Obstetrics
Background:
- Arterial hypertension and diabetes mellitus are prevalent risk factors for atherosclerosis.
- The co-occurrence of hypertension and diabetes is elevated, suggesting complex interactions beyond simple frequency.
- In women, diabetes mellitus equalizes cardiovascular risk with men, unlike the general population.
Purpose of the Study:
- To explore the cardiovascular risks associated with arterial hypertension and diabetes mellitus.
- To investigate the unique cardiovascular risk profiles of women with diabetes mellitus.
- To examine the impact of hypertension and diabetes during pregnancy on maternal and fetal outcomes.
Main Methods:
- Review of existing literature on hypertension, diabetes, and cardiovascular disease.
- Analysis of epidemiological data regarding risk factors in different populations.
- Discussion of the role of ambulatory blood pressure monitoring in pregnancy.
Main Results:
- The combination of hypertension and diabetes mellitus presents a heightened risk for atherosclerosis.
- Women with diabetes mellitus exhibit a cardiovascular risk comparable to men with diabetes.
- Gestational hypertension and diabetes negatively impact maternal and fetal prognosis, while reduced glucose tolerance in pregnancy is less critical.
Conclusions:
- The interplay between arterial hypertension and diabetes mellitus warrants further investigation due to their synergistic impact on cardiovascular health.
- Understanding sex-specific cardiovascular risks in diabetes is crucial for targeted prevention strategies.
- Ambulatory blood pressure monitoring aids in assessing hypertensive and diabetic pregnancies.
Abstract:
Arterial hypertension and diabetes mellitus are two important and frequent risk factors for atherosclerosis and their association in the same patients is particularly elevated, suggesting something more than the simple causality due to their frequency. In women with diabetes mellitus, the risk of cardiovascular complications is similar to that in men with diabetes mellitus, a pattern completely different from that in the general population where the cardiovascular risk in women is significantly lower than in men. During the gestational period, the glucose metabolism may be reduced and there may be an elevation of blood pressure with or without proteinuria and both conditions have a negative prognostic impact for the mother and for the fetus. On the contrary, reduced glucose tolerance during pregnancy does not seem to represent an important risk factor. The advent of ambulatory blood pressure monitoring has allowed one to evaluate in more detail the pattern of blood pressure in normal pregnancy or pregnancy complicated by diabetes mellitus or hypertension.