Abstract

A REVIEW: FINDING A LINK BETWEEN HYPERTENSION AND DIABETES

Nidhi Zar, Shivam Choudghal* and Rajat Sharma

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Abstract

Diabetes and Hypertension commonly occur together. There is considerable overlap between diabetes and hypertension in etiology and disease mechanisms. Obesity, inflammation, oxidative stress, and insulin resistance are thought to be the common pathways. Most patients with type 2 diabetes are insulin resistant, and about half of those with essential hypertension are insulin resistant. Therefore, insulin resistance is an important common link between diabetes and hypertension. Recent advances in the understanding of these pathways have provided new insights and perspectives. Physical activity plays an important protective role in the two diseases. By knowing the common causes and disease mechanisms allows us more effective and proactive approach in the prevention and treatment of the two diseases. Hypertension in the diabetic individual markedly increases the risk of cardiac disease, peripheral vascular disease, stroke, retinopathy, and nephropathy. Diabetic nephropathy is an important factor involved in the development of hypertension in diabetics, particularly type I patients. Increased sodium may also play a role in the pathogenesis of blood pressure in diabetics. There is increasing evidence that insulin resistance/hyperinsulinemia may play a key role in the pathogenesis of hypertension in both subtle and overt abnormalities of carbohydrate metabolism. Population studies suggest that elevated insulin levels, which often occurs in type II diabetes mellitus, is an independent risk factor for cardiovascular disease. Other cardiovascular risk factors in diabetic individuals include abnormalities of lipid metabolism, platelet function, and clotting factors. The goal of antihypertensive therapy in the patient with coexistent diabetes is to reduce the inordinate cardiovascular risk as well as lowering blood pressure.

Keywords: Diabetes, Hypertension, Obesity, Metabolic syndrome, Metabolic pathway, Insulin resistance, peripheral vascular disease, stroke, retinopathy, and nephropathy, insulin resistance/ hyperinsulinemia.