Most diabetics also have hypertension, which puts them at a higher risk to develop the complications of both diseases. The main concern is the effect that hypertension has on the kidneys and cardiovascular system of diabetics. There are medications, however, that are targeted to those diabetics who also have high blood pressure.
Goal of Treatment
Over 35 percent of the people who have hypertension also have diabetes, and an estimated 75 percent of diabetics have hypertension, according to Arash Rashidi, M.D., Fellow in the Division of Nephrology and Hypertension at University Hospitals, in his book "Hurst's The Heart." Having diabetes and hypertension puts that person at a higher risk for developing the complications of both diabetes and hypertension. Due to this, the treatment includes reducing the effect of both diseases on the kidneys and the heart.
Kidney Disease, Hypertension and Diabetes
Diabetes is the main cause of renal failure, also called end-stage renal disease, and hypertension increases the risk of renal failure. Dr. Rashidi notes in "Hurst's The Heart" that there have been several studies that show that lowering the blood pressure using a medication called an angiotensin II receptor blocker or one called an ACE inhibitor also slows the development of kidney disease in people who have diabetes. Thus, one of these medications should definitely be used in diabetics who also have hypertension.
Heart Disease, Hypertension and Diabetes
Ehud Grossman, M.D., wrote an article in the 2008 issue of "Advances in Cardiology," that stated that coronary artery disease of the heart and the enlargement of the lower left chamber of the heart are much more common in people who have hypertension and diabetes, than in people who have just hypertension or just diabetes. Therefore, lowering high blood pressure in a diabetic is not only important in slowing the development of kidney complications, but heart complications as well.
Recommendations
The U.S. Preventive Services Task Force recommends that adults with a blood pressure of at least 135/80 be checked for diabetes mellitus type 2 because they found that lowering the blood pressure in diabetics who have hypertension lowers future cardiovascular problems. Assessing the blood pressure and the risk for stroke helps the physician to decide how aggressive the treatment for hypertension in diabetics should be. Physicians even have a tool at their disposal, called a risk assessment calculator, to estimate the risk of having a heart attack in 10 years.
References
- Advances in Cardiology: Hypertension and diabetes
- "Hurst's The Heart"; Valentin Fuster, M.D., Ph.D., Robert O'Rourke, M.D., Philip Poole-Wilson, M.D., Richard Walsh, M.D.; 2008
- U.S. Preventive Services Task Force: Screening for Type 2 Diabetes Mellitus in Adults
