Diabetes and high blood pressure shares several common things like obesity is main cause for both diabetes and high blood pressure. It is believed that risk of cardiovascular diseases doubles if the patient suffers from both diabetes and high blood pressure. The control of sugar level and weight can help to reduce the prevalence of both the disease. Before jumping to treatment lets have some idea regarding these diseases.
Diabetes
In recent years, developed nations have witnessed an explosive increase in the prevalence of diabetes (endocrine disease) predominantly related to lifestyle changes. Diabetes is characterised by high blood sugar level (hyperglycaemia) due to less/no secretion of insulin or insulin resistance. Insulin is responsible for maintenance of blood sugar level in humans and animals also. It plays an important role to maintain body metabolic activities and disturbance in its synthesis or secretion may leads to various impaired physiological conditions.
It is estimated that more than 180 million people worldwide are afflicted with diabetes, and the number of diabetic patients will be double by the year 2030. now a day’s diabetes is common and one of the leading cause of death in developing countries.
Complications due to diabetes
Various complications are associated as diabetes causes various metabolic derangements in body. Diabetes leads to blood vessels disorder which can be either large-macro vascular disease or small disease-microangiopathy. Dysfunction of vascular endothelium is an early and critical event in the development of vascular complications. Here macro vascular diseases like atheroma and thrombotic complications while microangiopathy diseases are associated with retina, kidney and peripheral nerves. So ultimately after a prolonged period of time diabetes can lead to cardiovascular, eye as well as renal disease.
High Blood Pressure
Hypertension or high blood pressure is a most common cause of cardiovascular disease. Hypertension is said to be present when systolic blood pressure (SBP) is greater than 140 mm Hg or a diastolic blood pressure (DBP) is greater than 90 mm Hg. Hypertension can be primary or secondary in nature. When high blood pressure is due to other disease then it is known as secondary hypertension like for example it can arise form any cardiovascular diseases or due to endocrinal diseases like diabetes. the more common cause for high blood pressure is smoking, drinking alcohol, environmental factors, obesity and sedentary lifestyle. The prevalence of high blood pressure increases with age.
Diabetes and high blood pressure
Diabetes as well as hypertension depends on the life style of a person which shows that there’s great connection between diabetes and high blood pressure. Many research shows that diabetes eventually leads hypertension after long period of time. Patients with diabetes have a much higher rate of hypertension than that would be expected in the general population. Both diseases are likely to occur together because of shearing mechanisms as well as pathways.
Mechanism between Diabetes and high blood pressure
There are no specific mechanism which can describe direct relationship between diabetes and high blood pressure. But these two physiological conditions are most likely to occur together because of certain conditions caused by each disease to make other disease to occur. These conditions are –
- Increased fluid volume that directly leads to high blood pressure.
- Increased arteriolar stiffness that can increase peripheral resistance.5
- Impaired insulin handling – changes in the way the body produces and handles insulin can directly cause increases in blood pressure, but exact mechanism behind that is not clear.5
Having diabetes increases your risk of developing high blood pressure and other cardiovascular problems, because diabetes adversely affects the arteries, leads to atherosclerosis (hardening of the arteries). Atherosclerosis can cause high blood pressure, which if not treated, can lead to blood vessel damage, stroke, heart failure, heart attack, or kidney failure and also it can damage retina.
Management of diabetes and high blood pressure
Several lifestyle modifications are required as a precautionary measure or to control both diseases. This includes
- Decrease in salt intake. Avoid processed food preparation. Try to consume only one tablespoon full of salt in a day. daily recommended value is 2300mg of salt for an adult person.
- Decrease in sugar intake- Avoid canned preparation like juices or cola as they are loaded with sugar. Consume more fruits and vegetables since the sugar content in them is very less.
- Regular physical exercise- this helps to burn excess of fat and calories in body and reduces down your blood pressure.
- Avoid alcohol drinking
- Avoid smoking
- Go for proper and healthy diet- by healthy diet we mean there must be more consumption of fruits (4-5 servings per day), vegetables (4-5 servings per day), and cereals (2-3 servings per day), Fish (2 servings in a week), lean meat (2 servings in a week), low fat dairy products (2-3 servings a day).
- Stress management through yoga, exercise, massage and meditation.
All these non-pharmacological (without drug) treatment need to be supervise. Apart from non-pharmacological treatment there are pharmacological treatment is also available, which is more effective.
Some effective drugs treatment is available like ACE Inhibitors (captopril, enalapril etc.), diuretics (hydrochlorothiazide), CCB (calcium channel blockers – amlodipine, Nifedipine etc.), ARBs (angiotensin receptor blocker – losartan, olmisartan etc.). All these drugs must be given with antidiabetics like metformin, glipizide and other hypoglycaemic drugs to treat diabetes with high blood pressure.
Conclusion
At the end of this review article I would say that high blood pressure is associated with increased incidence of diabetes and it is more frequent and more prevalent with age. Hence, both the parameters like blood pressure & blood sugar level must be monitored, particularly in advanced ages and proper drug treatment with life style modification is necessary. A lot of work is being done and further research needs to be carried out to identify exact mechanism and relationship between diabetes and high blood pressure so that quality of healthcare can be improved.