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Hypertension and diabetes mellitus

M Marre1, G Berrut, B Bouhanick

  • 1Service de Médecine B, Centre Hospitalier Universitaire, Angers, France.

Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie
|January 1, 1993
PubMed

Insights

High blood pressure is common in people with diabetes, especially type II. Chronic high blood sugar and insulin resistance contribute to hypertension, necessitating careful blood pressure management in diabetic patients.

Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiovascular Medicine

Background:

  • Arterial hypertension frequently coexists with diabetes mellitus, affecting one-third of patients in diabetic clinics.
  • Type II (non-insulin-dependent) diabetes commonly presents with hypertension, often alongside obesity and lipid disorders, linked by insulin resistance.
  • In type I (insulin-dependent) diabetes, hypertension is frequently associated with diabetic nephropathy, potentially sharing genetic links with familial hypertension.

Purpose of the Study:

  • To explore the frequent association between arterial hypertension and diabetes mellitus.
  • To investigate the underlying mechanisms, including insulin resistance and chronic hyperglycemia, contributing to hypertension in diabetic patients.
  • To discuss therapeutic considerations for managing hypertension in diabetic individuals, particularly concerning kidney protection.

Main Methods:

  • Review of existing literature on the comorbidity of hypertension and diabetes.
  • Analysis of the roles of insulin resistance, obesity, lipid disorders, and chronic hyperglycemia.
  • Examination of genetic predispositions and the impact of diabetic nephropathy.
  • Discussion of therapeutic strategies, including target blood pressure and specific drug classes like ACE inhibitors.

Main Results:

  • Hypertension is highly prevalent in diabetic populations, particularly type II diabetes.
  • Insulin resistance and chronic hyperglycemia are key factors contributing to elevated blood pressure in diabetes.
  • Diabetic nephropathy in type I diabetes is a significant cause of hypertension, with potential genetic links.
  • Blood pressure above 140/90 mmHg is considered unacceptable in diabetic patients under 40.

Conclusions:

  • The association between arterial hypertension and diabetes is complex, involving shared risk factors and pathophysiological mechanisms.
  • Effective management of blood pressure is crucial for diabetic patients to prevent cardiovascular and renal complications.
  • Angiotensin I converting enzyme inhibitors show promise for protecting kidney function in diabetic individuals with hypertension.

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