Diabetes And High Blood Pressure
People with diabetes are more likely to also have high blood pressure or hypertension. High blood pressure can increase the risk of diabetes complications such as diabetic eye and kidney problems. Managing blood pressure will be a part of a person's overall diabetes care plan. Diabetes and high blood pressure complications Having diabetes increases your risk of developing high blood pressure and other cardiovascular problems, because diabetes adversely affects the arteries, predisposing them to atherosclerosis - narrowing of the arteries. Atherosclerosis can cause high blood pressure, which if not treated, can lead to further blood vessel damage, and stroke, heart failure, heart attack, and kidney failure. Compared with people with normal blood pressure readings, men and women with hypertension have an increased risk of: Strokes Peripheral vascular disease (narrowing of the arteries in the legs and feet) Heart failure Even high yet normal blood pressure or pre-hypertension (defined as 120-139/ 80-89 millimetres of mercury or mmHg) has an impact on your health. Studies show that people with normal yet high range blood pressure readings, over a 10-year period of follow up time, had a two to three-fold increased risk of heart disease. What should blood pressure be if you have diabetes? Blood pressure readings vary, but in general if someone has diabetes their blood pressure should be less than 130/80 mmHg. The first number is the "systolic pressure" or the pressure in the arteries when your heart beats and fills the arteries with blood. The second number is the "diastolic pressure" or the pressure in the arteries when your heart rests between beats, filling itself with blood for the next contraction. Having normal blood pressure is as important in managing diabetes as havi Continue reading >>
How Does Diabetes Cause Hypertension? The Importance Of Managing Blood Pressure
Every day the prevalence of type 2 diabetes continues to increase. It is projected that between the years 2000 to 2030, the number of people with diabetes will more than double. Similarly, the number of adults with hypertension is predicted to increase by nearly 60 percent. Hypertension is a very common condition in diabetics, but how does diabetes cause hypertension, and what can you do to help prevent or manage it? Hypertension, or high blood pressure, is generally considered blood pressure that's higher than 140/90 mmHg. A normal blood pressure is 120/80 mmHG for people without diabetes, and 130/80 mmHG for diabetics. There are often no symptoms of hypertension - thus it's important to get your blood pressure checked regularly, or purchase a home monitoring kit so that you can test it yourself at your convenience. Continued high blood pressure puts you at higher risk for additional complications including heart disease, stroke, and kidney disease. Being both diabetic and hypertensive can put you at even greater risk. Hypertension occurs because of a narrowing in the arteries. In diabetics, this can be caused by continued and consistently high blood glucose levels (a good reason to keep blood sugar levels under control). When the blood flow is restricted, the blood pressure increases. Diabetics can reduce their risk of developing hypertension -- and thus, additional complications due to hypertension -- by eating a healthy diet, getting regular exercise, maintaining a healthy body weight, and regularly monitoring their blood glucose levels and keeping them under control. Get your blood pressure checked regularly. Early treatment can help to get your blood pressure down to healthy levels. The information on this website is based on our own research and personal experien Continue reading >>
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Mechanisms Of Hypertension In Diabetes.
Abstract Hypertension in insulin resistance states is generally attributed to hyperinsulinemia, with resulting increases in renal sodium retention and/or sympathetic nervous system activity. However, recent data from our laboratory suggest that cellular insulin resistance, rather than hyperinsulinemia per se, may lead to hypertension. The basic tenet proposed in this review is that the common mechanism involved in the development of hypertension in both type I and type II diabetes mellitus is a deficiency of insulin at the cellular level. Recent observations suggest that impaired cellular response to insulin predisposes to increased vascular smooth muscle (VSM) tone (the hallmark of hypertension in the diabetic state). For example, recently reported studies from our laboratory demonstrate that insulin in physiological doses attenuates the vascular contractile response to phenylephrine, serotonin, and potassium chloride. Thus, insulin appears to normally modulate (attenuate) VSM contractile responses to vasoactive factors, and insulin resistance should accordingly be associated with enhanced vascular reactivity. Abnormal VSM cell calcium [Ca2+]i homeostasis may be the nexus between insulin resistance and increased VSM tone. The genetically obese, hyperinsulinemic, insulin-resistant Zucker rat demonstrates increased vascular reactivity, reduced membrane Ca2(+)-ATPase activity, increased cellular Ca2+ levels, and a marked impairment in vascular smooth muscle Ca2+ efflux compared to lean controls. Insulin stimulates membrane Ca-ATPase, blocks Ca2+ currents, and Ca2(+)-driven action potentials. Thus, an insulin-resistant state as exists in the Zucker rat may be associated with increased Ca2+ influx through voltage-dependent sarcolemmal Ca2+ channels and/or decreased producti Continue reading >>
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Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus
University of Gondar, Ethopia *Corresponding Author: Habtamu Wondifraw Baynes Lecturer Clinical Chemistry University of Gondar, Gondar Amhara 196, Ethiopia Tel: +251910818289 E-mail: [email protected] Citation: Baynes HW (2015) Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. J Diabetes Metab 6:541. doi:10.4172/2155-6156.1000541 Copyright: © 2015 Baynes HW. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycemia either immune-mediated (Type 1 diabetes), insulin resistance (Type 2), gestational or others (environment, genetic defects, infections, and certain drugs). According to International Diabetes Federation Report of 2011 an estimated 366 million people had DM, by 2030 this number is estimated to almost around 552 million. There are different approaches to diagnose diabetes among individuals, The 1997 ADA recommendations for diagnosis of DM focus on fasting Plasma Glucose (FPG), while WHO focuses on Oral Glucose Tolerance Test (OGTT). This is importance for regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Keywords Diabetes mellitus; Epidemiology; Diagnosis; Glycemic management Abbreviations DM: Diabetes Mellitus; FPG: Fasting Plasma Glucose; GAD: Glutamic Acid Decarboxylase; GDM: Gestational Diabetes Mellitus; HDL-cholesterol: High Density Lipoprotein cholesterol; HLA: Human Leucoid Antigen; IDD Continue reading >>
Diabetes And Stroke: Part One—risk Factors And Pathophysiology
Abstract Diabetes is a major risk factor for stroke and is associated with an increase in overall stroke mortality. The metabolic syndrome associated with insulin resistance is also a significant risk factor for stroke. The etiology of stroke in diabetics is frequently microvascular disease from fibrinoid necrosis, which causes small subcortical infarcts designated as lacunar strokes. Diabetics also have an increased incidence of large vessel intracranial vascular disease. Although strict control of blood sugar has not been shown to reduce the overall incidence of stroke in diabetics, careful management of other associated risk factors, particularly hypercholesterolemia and hypertension, are imperative for the prevention of stroke in diabetic patients. Preview Unable to display preview. Download preview PDF. Continue reading >>
Hypertension And Diabetes Mellitus
Login or register to view PDF. Order reprints There has been an increase in the prevalence of diabetes mellitus over the past 40 years, both in the US and worldwide. The worldwide prevalence of diabetes in 2000 was approximately 2.8% and is estimated to grow to 4.4% by 2030. This translates to a projected rise of diabetes from 171 million in 2000 to well over 350 million in 2030. 1 The epidemic of diabetes will continue to rise as there is growing prevalence of obesity in children, which predisposes to diabetes.2 There is considerable evidence for an increased prevalence of hypertension in diabetic persons.3 In a large prospective cohort study that included 12,550 adults, the development of type 2 diabetes was almost 2.5 times as likely in persons with hypertension than in their normotensive counterparts.3,4 Similarly, evidence points to increased prevalence of hypertension in diabetic persons.3,5 Moreover, each pathophysiological disease entity serves to exacerbate the other.3,6 Both hypertension and diabetes predisposes to the development of cardiovascular disease (CVD) and renal disease.7,8 Subjects with diabetes are at about 60% increased risk of early mortality.8,9 The age-adjusted relative risk of death due to cardiovascular events in persons with type 2 diabetes is three-fold higher than in the general population. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy.5,10,11 Indeed, when hypertension coexists with diabetes, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of an already high-risk population.5,12 Generally, hypertension in type 2 diabetic persons clusters with other CVD risk factors such as microalbuminur Continue reading >>
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Pathophysiology Of Hypertension In Diabetes Mellitus--implications For Management.
Abstract A variety of mechanisms may lead to the initiation and progression of hypertension in patients with diabetes mellitus; an understanding of their nature may provide a rational basis for the choice of management. Nevertheless, a decision on the management of an individual patient remains a matter of clinical skill and judgement. Continue reading >>
How Does Obesity Cause Hypertension?
Obesity is the increase in the body fat and occurs in both the sexes and can affect any age group. There are several factors which are associated with increasing the amount of body fat that results in obesity. Weight gain occurs when one eats more calories than your body uses. If the food you eat provides more calories than your body needs, the excess is converted to fat. The most important causes are: • Genetic • Metabolic • Psychological • Sociocultural • Sedentary lifestyle • High caloric nutrition • Multiple factors Obesity is also considered as one of the causes of hypertension and this has been proved in a number of researches. According to the population studies, it has been indicated that almost two-thirds of the people suffering from obesity are at risk of hypertension. Apart from an increased risk of hypertension, there are also risks associated to sleep apnea, coronary heart disease and congestive cardiac failure. Though the exact mechanism of how obesity is a cause for hypertension is unknown, but a lot can be attributed to the neuroendocrine mechanism and also the factors resulting from adipose tissue are considered to be a cause behind the link. Obesity is found to affect a number of hormonal levels in our body, the worst affected is the renin-angiotensin-aldosterone system. This system is responsible for controlling the blood volume of the body and along with the sympathetic nervous system; it controls the level of sodium and water retention in the body. Both these factors are responsible for the proper regulation of blood pressure and with obesity interfering with these systems, it can lead to hypertension. The adipose tissue deposition can lead to the irregular functioning of the kidney, which can lead to altering of the blood pressure. Fu Continue reading >>
Impact Of Diabetes On Cardiovascular Disease: An Update
Copyright © 2013 Alessandra Saldanha de Mattos Matheus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Cardiovascular diseases are the most prevalent cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The proposed mechanisms that can link accelerated atherosclerosis and increased cardiovascular risk in this population are poorly understood. It has been suggested that an association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction. Recently, epigenetic factors by different types of reactions are known to be responsible for the interaction between genes and environment and for this reason can also account for the association between diabetes and cardiovascular disease. The impact of clinical factors that may coexist with diabetes such as obesity, dyslipidemia, and hypertension are also discussed. Furthermore, evidence that justify screening for subclinical atherosclerosis in asymptomatic patients is controversial and is also matter of this review. The purpose of this paper is to describe the association between poor glycemic control, oxidative stress, markers of insulin resistance, and of low-grade inflammation that have been suggested as putative factors linking diabetes and cardiovascular disease. 1. Introduction Diabetes is an important chronic disease which incidence is globally increasing and though considered as an epidemic [1]. The World Health Organization (WHO) estimated there were 30 million people who had diabetes worldwide in 1985. This number increased to 135 Continue reading >>
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Hypertension
Definition and Etiology Normal or optimal blood pressure (BP) is defined as the level above which minimal vascular damage occurs. There is a continuous, consistent, and independent relationship between elevated BP and risk of cardiovascular events. This was clearly demonstrated in a meta-analysis that included 1,000,000 individuals with no history of vascular disease. Among this group, during 12.7 million person-years at risk, there were about 56000 deaths categorized as vascular in origin (12000 stroke, 34000 ischemic heart disease, and 10000 “other vascular”) and 66000 other deaths at ages 40-89 years.1 Results from this study demonstrated that a BP level lower than 115/75 mmHg appears to better define optimal BP.1 According to the Joint National Committee 7 (JNC 7), hypertension is defined as physician office systolic BP level of ≥140mmHg and diastolic BP of ≥90mmHg. The JNC 7 defines normal BP as a systolic BP <120mmHg and diastolic BP <80mmHg. The gray area between systolic BP of 120-139 mmHg and diastolic BP of 80-89 mmHg is defined as “prehypertension.”2 Prevalence and Risk Factors One in 3 Americans over the age of 18 years suffers from hypertension. The prevalence is higher among older individuals, women and non-Hispanic blacks. Despite the increase in prevalence, recent data from the National Health and Nutrition Examination Survey (NHANES) demonstrate an improvement in blood pressure control (50%) among Americans with hypertension.3 However, the blood pressure control rate remains suboptimal in people who have serious comorbid conditions such as chronic kidney disease. In a survey of patients with chronic kidney disease, BP control was found to be just 13.2%.4 On a global level, hypertension is a greater problem, with 13.5% of all deaths attribute Continue reading >>
Diabetes And Hypertension: What Is The Relationship?
Hypertension, also known as high blood pressure, often affects people with type 1 and type 2 diabetes. The American Diabetes Association reports that from 2000 to 2012, 71 percent of adults with diabetes had a blood pressure of greater or equal to 140/90 or were taking medications to help normalize blood pressure. What are hypertension and diabetes Many people with diabetes also have hypertension, or high blood pressure. Having these conditions together can make them both worse. What is hypertension? Known the "silent killer," hypertension usually has no signs or symptoms and many people are not aware they have it. High blood pressure increases a person's risk of stroke and heart attack. It often occurs with diabetes. Blood pressure is measured in millimeters of mercury (mm Hg) and can be assessed using a blood pressure monitor. Two numbers will be produced. The first refers to the systolic blood pressure, or the highest level of the blood pressure during a heartbeat. The second, the diastolic blood pressure, points to the lowest level. Any blood pressure reading of less than or equal to 119/79 is considered normal. A reading between 120 and 139 for systolic pressure and between 80 and 89 for diastolic pressure is considered prehypertension. This is a sign of possible hypertension if a person does not take preventive steps. A doctor will diagnose a reading of 140/90 mm Hg or higher as high blood pressure. People can control hypertension with healthy lifestyle habits. These can include exercise and a low-fat, low-sodium diet. If necessary, a person with hypertension may reduce their blood pressure using medication. What is diabetes? Diabetes occurs when blood sugar increases because the body cannot use the glucose properly. This happens when there a problem with insulin Continue reading >>
Hyperglycemia (high Blood Sugar)
Hyperglycemia is a hallmark sign of diabetes (both type 1 diabetes and type 2 diabetes) and prediabetes. Other conditions that can cause hyperglycemia are pancreatitis, Cushing's syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses. The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNS, also referred to as hyperglycemic hyperosmolar state). Insulin is the treatment of choice for people with type 1 diabetes and for life-threatening increases in glucose levels. People with type 2 diabetes may be managed with a combination of different oral and injectable medications. Hyperglycemia due to medical conditions other than diabetes is generally treated by treating the underlying condition responsible for the elevated glucose. Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels A number of medical conditions can cause hyperglycemia, but the most common by far is diabetes mellitus. Diabetes affects over 8% of the total U.S. population. In diabetes, blood glucose levels rise either because there is an insufficient amount of insulin in the body or the body cannot use insulin well. Normally, the pancreas releases insulin after a meal so that the cells of the body can utilize glucose for fuel. This keeps blood glucose levels in the normal range. Type 1 diabetes is responsible for about 5% of all cases of diabetes and results from damage to the insulin-secreting cells of the pancreas. Type 2 diabetes is far more common and is related to the body's inability to effectively use insulin. In addition to type 1 and type 2, gestational diabe Continue reading >>
Hypertension Complicating Diabetic Pregnancies: Pathophysiology, Management, And Controversies
Abstract Hypertensive disorders of pregnancy (HDP), including pre-existing hypertension, gestational hypertension, and preeclampsia, further complicate already high-risk pregnancies in women with diabetes mellitus (DM). Women with both pre-existing and gestational diabetes are at increased risk for HDP, leading to higher maternal and fetal morbidity. Further, particularly in diabetic women and women with a history of gestational diabetes, HDP significantly increases the risk for future cardiovascular events. For clinicians, women with hypertension and diabetes during pregnancy pose a management challenge. Specifically, preconception management should stress strict control of glycemia, blood pressure, and prevention of diabetic complications, specifically nephropathy, which specifically increases the risk for preeclampsia. During gestation, clinicians must be aware of potential maternal and fetal complications associated with various anti-hypertensive therapies, including known fetotoxicity of ACE inhibitors and ARBs when given in the 2nd or 3rd trimester, and the risks and benefits of expectant management versus delivery in cases of severe gestational hypertension or preeclampsia. Indeed, diabetic women must be followed closely prior to conception and throughout gestation to minimize the risk of HDP and its associated complications. J Clin Hypertens (Greenwich). 2011;13:275–284. © 2011 Wiley Periodicals, Inc. Hypertensive disorders complicate 5% to 10% of all pregnancies and are a leading cause of maternal and fetal morbidity and mortality. Hypertension during pregnancy frequently leads to preterm delivery, intrauterine growth restriction (IUGR), placental abruption, and small-for-gestational-age (SGA) infants.1 In women with diabetes mellitus (DM), hypertension adds Continue reading >>
High Blood Pressure (hypertension)
Print Overview High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. High blood pressure generally develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it. Symptoms Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren't specific and usually don't occur until high blood pressure has reached a severe or life-threatening stage. When to see a doctor You'll likely have your blood pressure taken as part of a routine doctor's appointment. Ask your doctor for a blood pressure reading at least every two years starting at age 18. If you're age 40 or older, or you're age 18-39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year. Blood pressure generally should be checked in both arms to determine if there is a difference. It's import Continue reading >>
Pathophysiology And Pathogenesis Of Type 2 Diabetes
Type 2 Diabetes Overview Type 2 Diabetes at the Cellular Level Pathophysiology of Type 2 Diabetes Insulin Resistance The Impact of Cortisol Cellular Inflammation Advanced Glycation End Products (AGEs) The 7 Stages of Type 2 Diabetes Pathogenesis Red Blood Cell Lifecycle Why Understanding Diabetes Is So Important Next Steps to Reverse Your Diabetes Clinical References Author Sidebar: When I was in the hospital (and after I came out of the coma), I remember the doctors and nurses telling me that I had Type 2 diabetes. They said I had a very severe blood sugar problem because my blood sugar was over 1300. And, because my blood sugar was so high, I was given insulin to bring my blood sugar back down. At the time, this all made sense to me. So, I concluded (at that time) that once my blood sugar returned to normal, everything would be okay. But, instead, I was told that once my blood sugar returned to normal, everything would not be okay because I would still be diabetic. Needless to say, this was confusing and disheartening. But, I quickly realized that "high blood sugar" was not the real problem! -- it was a symptom of the problem. And, the real problem of having Type 2 diabetes was more than just a blood sugar problem. Type 2 diabetes is the most common form of diabetes, with more than 90% of diabetics being Type 2; and, 5% to 10% being Type 1. Type 2 diabetes mellitus is a heterogeneous disorder with varying prevalence among different ethnic groups. In the United States the populations most affected are Native Americans, particularly in the desert Southwest, Hispanic-Americans, African-Americans, and Asian-Americans. However, Caucasian-Americans are also affected, but not at the same disproportionate percentage levels. Type 2 Diabetes Impacts ALL groups and cultures! The Continue reading >>
