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Type 2 diabetes mellitus and hypertension: an update
Guido Lastra1, Sofia Syed2, L Romayne Kurukulasuriya3
1Division of Endocrinology, Diabetes & Metabolism, Department of Internal Medicine, University of Missouri Columbia School of Medicine, D109 Diabetes Center HSC, One Hospital Drive, Columbia, MO 65212, USA; Diabetes and Cardiovascular Research Center, University of Missouri, One Hospital Drive, Columbia, MO 65212, USA; Harry S Truman Memorial Veterans Hospital, 800 Hospital Drive, Columbia, MO 65201, USA.
Abstract:
Patients with hypertension and type 2 diabetes are at increased risk of cardiovascular and chronic renal disease. Factors involved in the pathogenesis of both hypertension and type 2 diabetes include inappropriate activation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, impaired insulin-mediated vasodilatation, augmented sympathetic nervous system activation, altered innate and adaptive immunity, and abnormal sodium processing by the kidney. The renin-angiotensin-aldosterone system blockade is a key therapeutic strategy in the treatment of hypertension in type 2 diabetes. Emerging therapies for resistant hypertension as often exists in patients with diabetes, include renal denervation and carotid body denervation.
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