Department of Medicine, Southern Ohio Medical Center, Portsmouth, Ohio, USA.
Department of Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey.
Curr Opin Cardiol. 2020 Jul;35(4):397-404. doi: 10.1097/HCO.0000000000000748.
Herein, we provide a review of the recent literature on the epidemiological and pathophysiological relationship between hypertension (HTN) and diabetes mellitus, along with prognostic implications and current treatment concepts.
Diabetes mellitus affects ∼10% of US adults. The prevalence of HTN in adults with diabetes mellitus was 76.3% or 66.0% based on the definitions used by guidelines. There exist differences among major society guidelines regarding the definition of HTN and target blood pressure (BP) levels. Recent basic and clinical research studies have shed light on pathophysiologic and genetic links between HTN and diabetes mellitus. Randomized controlled trials over the past 5 years have confirmed the favorable BP and cardiovascular risk reduction by antidiabetic agents.
HTN and diabetes mellitus are 'silent killers' with rising global prevalence. The development of HTN and diabetes mellitus tracks each other over time. The coexistence of both clinical entities synergistically contributes to micro- and macro-vasculopathy along with cardiovascular and all-cause mortality. Various shared mechanisms underlie the pathophysiological relationship between HTN and diabetes mellitus. Moreover, BP reduction with lifestyle interventions and antihypertensive agents is a primary target for reducing cardiovascular risk among patients with HTN and diabetes mellitus.
本文回顾了高血压 (HTN) 和糖尿病之间的流行病学和病理生理学关系，以及其预后意义和当前的治疗理念。
糖尿病影响了约 10%的美国成年人。根据指南中使用的定义，糖尿病患者中 HTN 的患病率为 76.3%或 66.0%。主要学会指南之间在 HTN 的定义和目标血压 (BP) 水平方面存在差异。最近的基础和临床研究阐明了 HTN 和糖尿病之间的病理生理和遗传联系。过去 5 年的随机对照试验证实了抗糖尿病药物对 BP 和心血管风险的降低作用。
HTN 和糖尿病是具有全球发病率上升趋势的“沉默杀手”。HTN 和糖尿病的发生随时间相互关联。这两种临床病症同时存在会协同导致微血管和大血管病变，以及心血管和全因死亡率增加。HTN 和糖尿病之间的病理生理关系存在多种共同的机制。此外，通过生活方式干预和降压药物降低 BP 是降低 HTN 和糖尿病患者心血管风险的主要目标。
