Diabetes and hypertension: The bad companions

Ele Ferrannini, William Cushman

Research output: Contribution to journalArticle

210 Citations (Scopus)

Abstract

High blood pressure is reported in over two-thirds of patients with type 2 diabetes, and its development coincides with the development of hyperglycaemia. Many pathophysiological mechanisms underlie this association. Of these mechanisms, insulin resistance in the nitric-oxide pathway; the stimulatory effect of hyperinsulinaemia on sympathetic drive, smooth muscle growth, and sodium-fluid retention; and the excitatory effect of hyperglycaemia on the renin-angiotensin-aldosterone system seem to be plausible. In patients with diabetes, hypertension confers an enhanced risk of cardiovascular disease. A blood pressure of lower than 140/85 mm Hg is a reasonable therapeutic goal in patients with type 2 diabetes according to clinical trial evidence. People with controlled diabetes have a similar cardiovascular risk to patients without diabetes but with hypertension. A renin-angiotensin system blocker combined with a thiazide-type diuretic might be the best initial antihypertensive regimen for most people with diabetes. In general, the positive effects of antihypertensive drugs on cardiovascular outcomes outweigh the negative effects of antihypertensive drugs on glucose metabolism.

Original languageEnglish (US)
Pages (from-to)601-610
Number of pages10
JournalThe Lancet
Volume380
Issue number9841
DOIs
StatePublished - Jan 1 2012

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Antihypertensive Agents
Hypertension
Renin-Angiotensin System
Hyperglycemia
Type 2 Diabetes Mellitus
Sodium Chloride Symporter Inhibitors
Hyperinsulinism
Smooth Muscle
Insulin Resistance
Nitric Oxide
Cardiovascular Diseases
Sodium
Clinical Trials
Blood Pressure
Glucose
Growth
Therapeutics

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Diabetes and hypertension : The bad companions. / Ferrannini, Ele; Cushman, William.

In: The Lancet, Vol. 380, No. 9841, 01.01.2012, p. 601-610.

Research output: Contribution to journalArticle

Ferrannini, Ele ; Cushman, William. / Diabetes and hypertension : The bad companions. In: The Lancet. 2012 ; Vol. 380, No. 9841. pp. 601-610.
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