Related Experiment Videos

Hypertension and diabetes

Ehud Grossman1, Franz H Messerli

  • 1Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Israel.

Advances in Cardiology
|January 31, 2008
PubMed

Insights

Hypertension and diabetes significantly increase cardiovascular risk by damaging blood vessels. Effective management involves aggressive blood pressure control and choosing medications beneficial for metabolic profiles.

Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology

Background:

  • Essential hypertension and diabetes mellitus share common target organ damage, primarily affecting the vascular tree.
  • Combined hypertension and diabetes accelerate renal function decline, diabetic retinopathy, and cerebral diseases.
  • Left ventricular hypertrophy and coronary artery disease are more prevalent in patients with both conditions.

Purpose of the Study:

  • To outline the impact of combined hypertension and diabetes on target organ damage.
  • To discuss optimal blood pressure management strategies in diabetic patients.
  • To review the effects of different antihypertensive drug classes on metabolic risk factors.

Main Methods:

  • Review of existing literature on the pathophysiology and management of coexisting hypertension and diabetes.
  • Analysis of the effects of various antihypertensive medications on cardiovascular and metabolic risk profiles.
  • Discussion of combination therapy and adjunct treatments for resistant hypertension.

Main Results:

  • Beta-blockers may negatively impact the metabolic risk factor profile in diabetic patients.
  • Calcium antagonists, ACE inhibitors, and ARBs are neutral or beneficial for metabolic profiles.
  • Combination therapy is often necessary to achieve blood pressure goals in diabetic patients.

Conclusions:

  • Aggressive control of blood pressure, cholesterol, and glucose is crucial for reducing cardiovascular risk in hypertensive diabetic patients.
  • Medication choice is critical, favoring agents with neutral or beneficial metabolic effects.
  • Aldosterone antagonists may benefit specific patient groups with resistant hypertension.

Related Concept Videos

Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Alterations in Blood Pressure01:30

Alterations in Blood Pressure

Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...