Hypertension in Diabetic Patients

High Blood Pressure In People With Diabetes

Although hypertension does not cause diabetes, it is clear that lowering blood pressure can reduce the risk of developing the disease.

Hypertension and diabetes are two chronic diseases and major cardiovascular risk factors. However, they also tend to be linked very frequently, not by chance, but by a common mechanism between the two diseases. Patients with hypertension have a 50% increased risk of developing type 2 diabetes.

High blood pressure may also increase the risk of diabetes-related complications, such as eye problems (retinal damage, cataracts, glaucoma) and kidney disease. On the other hand, diabetes has a negative impact on the arteries and increases the risk of developing hypertension and other cardiovascular diseases, which can lead to atherosclerosis or narrowing of the arteries.

In cases where it is clear that lowering blood pressure reduces the risk of developing diabetes, hypertension has not been shown to cause diabetes.

Hypertension and diabetes are two chronic diseases and two major cardiovascular risk factors. However, it is no coincidence that they also tend to be linked very frequently, as there are common mechanisms between the two diseases. People with hypertension have a 50% higher risk of developing type 2 diabetes (adult-onset diabetes).

It is not clear that high blood pressure causes diabetes, but it is clear that lowering blood pressure reduces the risk of developing diabetes. High blood pressure also increases the risk of diabetes-related complications, such as eye problems (retinal damage, cataracts, glaucoma) and kidney disease. On the other hand, diabetes adversely affects the arteries, increasing the risk of developing hypertension and other cardiovascular problems and predisposing to atherosclerosis, also known as arterial narrowing).

Hypertension affects more than 20% of the world’s population, while diabetes is considered to be the most common metabolic disease. Most statistics show that 3-4% of the population is diabetic. The maximum age of onset is around 60 years and accounts for 5-10% of elderly cases. In children, the frequency is 1 in 500-1000.

Several epidemiological studies have shown that about 40-60% of diabetic patients have hypertension. In diabetic patients requiring insulin, hypertension is usually diagnosed several years after the onset of diabetes and when renal function begins to decline. In contrast, in adults with diabetes, hypertension is usually diagnosed at the same time as or before diabetes.

A blood pressure cuff is all that is needed to diagnose hypertension, but it must be diagnosed by a physician because blood pressure levels fluctuate greatly throughout the day and multiple readings are required to make the diagnosis. In most cases, diabetes only requires a blood test to measure glucose levels, but more advanced tests may be needed to make the diagnosis.

Diabetes almost always presents with very characteristic symptoms, whereas hypertension is usually asymptomatic. Therefore, all people, especially those with diabetes, should have their blood pressure checked regularly. These symptoms include:

Increased appetite (polyphagia) is due to the non-use of carbohydrates and their excretion in the urine. This, combined with the use of fat as a source of energy, leads to weight loss and fatigue, which is very common in these patients.
Increased urination and volume of urine due to the kidneys eliminating excess blood sugar and carrying large amounts of water (polyuria). Thirst and loss of water through urine, causing the person to drink a lot of water to compensate (polyuria).

Not everyone with diabetes will have these symptoms; some patients may have only one or two of these symptoms, some may not have any discomfort, and some may be detected by the presence of some complications.

The most common secondary symptoms are

Delayed wound healing.
General or genital pruritus.
A tendency to skin infections (boils).
Gum infections.
Changes in visual acuity.
Pain or numbness in the extremities.

Symptoms are more pronounced in adolescents and children than in adults and the elderly, who are commonly diagnosed arbitrarily for other reasons in routine examinations.

It is important to note that, like other metabolic diseases and hypertension, the consequences of diabetes can be prevented or at least greatly reduced if the condition is well managed.

Diabetes accelerates the aging of arteries throughout the body and causes atherosclerosis, which increases the risk of stroke, myocardial infarction, peripheral vascular disease, and poor wound healing in the lower extremities.

The kidneys of diabetics eventually fail (nephropathy), putting them at risk for chronic kidney failure and dialysis. Some of the other risks include:

Damage to the nervous system due to the destruction of the myelin layer around nerves (diabetic neuropathy), leading to sensory impairment, especially in the lower extremities, and sexual impotence in men.
Trauma to the foot (diabetic foot)
Fertility problems when diabetes is not adequately compensated for.
Sexual dysfunction in men and women.
Ketoacidosis a clinical manifestation of excess glucose in the blood, leading to the risk of dehydration and possibly diabetic coma.
Hypoglycemia a clinical manifestation of an excessive drop in blood glucose levels due to overdose of insulin or oral antidiabetic medication, inadequate or delayed food intake, excessive exercise, or a combination of these causes. Symptoms include sweating, dizziness, tremors, weakness, and loss of consciousness.

Hypertension exacerbates and accelerates the arterial damage caused by diabetes, making it more common for people with hypertension and diabetes to have