Department of Physiology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.
Int J Mol Sci. 2022 Jun 10;23(12):6500. doi: 10.3390/ijms23126500.
Elevated blood pressure and hyperglycaemia frequently coexist and are both components of metabolic syndrome. Enhanced cardiovascular risk is strongly associated with diabetes and the occurrence of hypertension. Both hypertension and type 2 diabetes, if treated inappropriately, lead to serious complications, increasing the mortality of patients and generating much higher costs of health systems. This is why it is of great importance to find the missing link between hypertension and diabetes development and to simultaneously search for drugs influencing these two disorders or even drugs aimed at their pathological bases. Standard antihypertensive therapy mainly focuses on blood pressure reduction, while novel drugs also possess a wide range of pleiotropic modes of actions, such as cardio- and nephroprotective properties or body weight reduction. These properties are especially desirable in a situation when type 2 diabetes coexists with hypertension. This review describes the connections between diabetes and hypertension development and briefly summarises the current knowledge regarding attempts to define targets for the treatment of high blood pressure in diabetic patients. It also describes the standard hypotensive drugs preferred in patients with type 2 diabetes, as well as novel drugs, such as finerenone, esaxerenone, sodium-glucose co-transporter-2 inhibitors, glucagon-like peptide-1 analogues and sacubitril/valsartan.
高血压和高血糖常并存，均为代谢综合征的组成部分。增强的心血管风险与糖尿病和高血压的发生密切相关。高血压和 2 型糖尿病如果治疗不当，会导致严重的并发症，增加患者的死亡率，并产生更高的医疗系统成本。这就是为什么找到高血压和糖尿病发展之间缺失的联系，以及同时寻找影响这两种疾病的药物，甚至是针对其病理基础的药物，非常重要的原因。标准的降压治疗主要侧重于降低血压，而新型药物还具有广泛的多效作用模式，如心脏和肾脏保护特性或体重减轻。当 2 型糖尿病与高血压并存时，这些特性尤其理想。本文综述了糖尿病和高血压发展之间的联系，并简要总结了目前关于确定糖尿病患者高血压治疗靶点的尝试的知识。它还描述了在 2 型糖尿病患者中首选的标准降压药物，以及新型药物，如非奈利酮、依帕列净、钠-葡萄糖共转运蛋白 2 抑制剂、胰高血糖素样肽-1 类似物和沙库巴曲缬沙坦。
