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Diabetes and hypertension in the elderly
M Varricchio1, G Paolisso, R Torella
1Istituto di Gerontologia e Geriatria, 1st Medical School, University of Naples, Italy.
Summary
Elderly patients with hypertension and diabetes exhibit insulin resistance and hyperinsulinaemia, contributing to increased peripheral resistance. Low-dose thiazide diuretics, calcium channel blockers, and alpha-adrenergic blockers are recommended treatments.
Area of Science:
- Gerontology
- Cardiology
- Endocrinology
Background:
- Hypertension and diabetes mellitus in the elderly present complex metabolic and cardiovascular challenges.
- Key metabolic alterations include insulin resistance, hyperinsulinaemia, and elevated total peripheral resistance.
- Non-insulin dependent diabetes mellitus shares characteristics of insulin resistance and hyperinsulinaemia.
Purpose of the Study:
- To elucidate the role of hyperinsulinaemia in the pathophysiology of hypertension among elderly diabetic patients.
- To identify optimal pharmacological treatments for elderly individuals with co-existing hypertension and diabetes.
Main Methods:
- Review of existing literature on metabolic and cardiovascular changes in elderly patients with hypertension and diabetes.
- Analysis of the relationship between insulin resistance, hyperinsulinaemia, and total peripheral resistance.
- Evaluation of treatment strategies for this patient population.
Main Results:
- Hyperinsulinaemia is identified as a significant factor in the increased total peripheral resistance observed in elderly hypertensive diabetic patients.
- Insulin resistance and hyperinsulinaemia are common features in both conditions.
Conclusions:
- Hyperinsulinaemia plays a crucial role in the development of hypertension in elderly individuals with diabetes.
- Recommended treatments include low-dose thiazide diuretics, calcium channel blockers, and alpha-adrenergic blockers for elderly hypertensive diabetic patients.