23/04/2020

Hypertension has a role as a major risk factor for cardiovascular disease and, particularly, in patients with diabetes mellitus. Thus, several pathogenic mechanisms have been proposed to explain the association between diabetes mellitus and hypertension. These mechanisms seems to be mediated through the adrenergic system in both diseases.

It has been demonstrated that patients with uncontrolled blood pressure despite the use of medication are at increased risk for developing diabetes mellitus.

According to results of a study carried out in the UK, patients with hypertensión present about a 50% increased risk of developing type 2 diabetes. This research was a large cohort study and systematic review with meta-analysis. Baseline measurements of patiens included body mass index, cholesterol and smoking status. The main outcome measures were diagnosis of diabetes or the prescription of drugs. The authors concluded that patients with hypertension presents an increased risk of diabetes. The strength of this association decreased with elevated body mass index and age.

Classes of pharmacologic antihypertensive agents have been demonstrated different efficacy in blood pressure control and also in clinical outcomes such as cardiac and renal protection as well as in proteinuria reduction.

When considering recommendations from guidelines, it is important to have into account that the management of hypertension in patients with diabetes should be individualized. Even though current guideliness mean a tremendous help in clinical decisions in diabetic patient care, further evidence-based medine is required to minimizing the consequences of diabetic macro/microvascular disease.

Autor: Ana Martín