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Diabetes and Hypertension: What Is the Connection?

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Hypertension and Cardiovascular Disease in Asia

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

Abstract

Diabetes mellitus, along with hypertension and dyslipidaemia, are important risk factors for atherosclerotic cardiovascular disease (ASCVD), which is a major cause of mortality and morbidity worldwide. Several pathophysiologic mechanisms are common to both diabetes and hypertension, including oxidative stress due to reactive oxygen species (ROS), activation of the renin-angiotensin-aldosterone system (RAAS), inflammation, blunted insulin-mediated vasodilatation, sympathetic nervous system (SNS) activation, dysfunctional innate and adaptive immune responses, and impaired renal handling of sodium. The organs affected are similar in both essential hypertension and diabetes mellitus, with the vascular tree being the common target. The relative risk of hypertension in populations with versus without diabetes varies from 4.7 to 7.7. In addition, each 20-mmHg increase in systolic blood pressure increases the risk of new-onset type 2 diabetes mellitus by 77%.

The “rule of halves” in diabetes and hypertension states that more than 50% of people with either of these conditions remain undiagnosed, 50% of those in whom the disease is detected are untreated treatment, and 50% of those receiving treatment do not achieve disease control. Thus, the overall proportion of patients with diabetes mellitus or hypertension who are adequately controlled is small. The ideal management of diabetes requires identification and optimisation of the “ABCDEs” of diabetes: A1C (glycosylated haemoglobin; HbA1c), blood pressure, cholesterol (i.e., dyslipidaemia), diet and exercise. Targeting diabetes at all levels of prevention, including primordial prevention, primary prevention, secondary prevention and tertiary prevention, along with control of comorbidities, especially hypertension, and good strategies to promote vascular health, will be important in reducing the microvascular and macrovascular complications of diabetes.

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Authors and Affiliations

  1. Dr. Mohan’s Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India

    Mukundan Aswin & Viswanathan Mohan

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  1. Mukundan Aswin
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  2. Viswanathan Mohan
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Correspondence to Viswanathan Mohan .

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Editors and Affiliations

  1. Apollo Hospitals, Apollo Institute for Blood Pressure Management, Hyderabad, India

    C. Venkata S. Ram

  2. Head, Division of Nephrology Department of Medicine, Yong Loo Lin Sch of Med Natl Univ of Sin, Singapore, Singapore

    Boon Wee Jimmy Teo

  3. Department of Cardiology, Hero DMC Heart Institute, Dayanand Medical College, Ludhiana, Punjab, India

    Gurpreet S. Wander

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Aswin, M., Mohan, V. (2022). Diabetes and Hypertension: What Is the Connection?. In: Ram, C.V.S., Teo, B.W.J., Wander, G.S. (eds) Hypertension and Cardiovascular Disease in Asia. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-030-95734-6_12

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  • DOI: https://doi.org/10.1007/978-3-030-95734-6_12

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