Diabetes mellitusCardio vascular diseasesHypertension
Diabetes mellitus and hypertension are interrelated diseases that strongly predispose an individual to atherosclerotic cardiovascular disease.1 2 An estimated 3 million Americans have both diabetes and hypertension.2 Hypertension is about twice as frequent in individuals with diabetes as in those without.2 Lifestyle and genetic factors are important factors contributing to both hypertension and diabetes mellitus. The prevalence of coexisting hypertension and diabetes appears to be increasing in industrialized nations because populations are aging and both hypertension and NIDDM incidence increases with age.1 2 Data obtained from death certificates show that hypertensive disease has been implicated in 4.4% of deaths coded to diabetes, and diabetes was involved in 10% of deaths coded to hypertensive disease.1 2 Indeed, an estimated 35% to 75% of diabetic cardiovascular and renal complications can be attributed to hypertension.1 2 Hypertension also contributes to diabetic retinopathy, which is the leading cause of newly diagnosed blindness in the United States.2 For all these reasons, hypertension and diabetes should be recognized and treated early and aggressively.
Essential hypertension accounts for the majority of hypertension in individuals with diabetes, particularly those with NIDDM (type II diabetes), who constitute more than 90% of people with a dual diagnosis of diabetes and hypertension.1 2 Hypertension often antedates and likely contributes to the development of nephropathy in many diabetic individuals.3 4 Diabetic nephropathy, which occurs after 15 years of diabetes in one third of people with IDDM (type I diabetes) and 20% of those with NIDDM, is an important contributing factor to the development of hypertension in the diabetic individual.1 2 The high BP associated with diabetic nephropathy is usually characterized by sodium and fluid retention and increased peripheral vascular resistance.1 2 Isolated systolic hypertension is considerably more common in diabetics, and supine hypertension with orthostatic hypotension is not uncommon in diabetic individuals with autonomic neuropathy.1 2
Increasing investigation has delineated an important role for several mechanisms acting together in mediating the pathogenesis of vascular disease in the diabetic hypertensive patient. We will review some of the more important mechanisms of cardiovascular and renal injury associated with diabetes mellitus and hypertension.
Diabetes mellitus
The disease can be diagnosed by blood test or urine test.
Causes
(i) Less secretion of insulin hormone from the pancreas.
(ii) Mental stress
(iii) Through heredity from parents to children.
Symptoms
(i) More glucose in blood.
(ii) Excessive and frequent passing of urine.
(iii) Feeling thirsty and hungry frequently.
(iv) Reduced healing capacity of injury.
(v) General weakness of the body.
(vi) In extreme cases diabetic coma can take place making the patient unconscious.
Prevention and cure
(i) Control the excessive weight of the body.
(ii) A regulated and controlled diet is to be taken.
(iii) The food should not contain sugar and much carbohydrates.
(iv) Injection of insulin before meals, if required (only on doctor’s prescription).
