Hezam Ali Ahmed Mohammed, Shaghdar Hanan Basheer Mohammed, Chen Liying
Department of General Practice, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
School of Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
J Res Med Sci. 2024 Apr 29;29:22. doi: 10.4103/jrms.jrms_470_23. eCollection 2024.
Hypertension and diabetes are two common metabolic disorders that often coexist in the same individual. Their concurrence increases the risk of cardiovascular disease, renal dysfunction, and other complications. Cardiovascular disease is the primary cause of morbidity and mortality in individuals with diabetes, and hypertension further aggravates this condition. Interestingly, hypertension and diabetes share several common pathophysiological mechanisms including insulin resistance, vascular inflammation, endothelial dysfunction, obesity, and oxidative stress suggesting a cross-talk between these two conditions that could potentially contribute to the development of other human diseases. Effective management of diabetes should include a multifaceted approach that addresses not only glycemic control but also blood pressure (BP) and lipid control. Treatment plans should be individualized to each patient's needs and should involve a combination of lifestyle modifications and medications to achieve optimal control. With the availability of newer antidiabetic medications such as SGLT inhibitors and GLP1 receptor agonists, it is crucial to consider their potential to reduce BP, enhance kidney function, and lower the risk of cardiovascular diseases when initiating treatment for glycemic control. A more profound comprehension of the shared underlying mechanisms between these conditions could pave the way for the development of innovative therapeutic approaches to tackle them. Our review offers an in-depth analysis of the literature, providing a holistic view of the mechanisms underlying diabetes-hypertension comorbidity and its implications on heart and kidney diseases. The present article concludes by discussing current approaches for managing hypertensive diabetic patients to create a set of comprehensive individualized recommendations.
高血压和糖尿病是两种常见的代谢紊乱疾病，常共存于同一个体。它们的并发会增加心血管疾病、肾功能障碍及其他并发症的风险。心血管疾病是糖尿病患者发病和死亡的主要原因，而高血压会进一步加重这种情况。有趣的是，高血压和糖尿病有几种共同的病理生理机制，包括胰岛素抵抗、血管炎症、内皮功能障碍、肥胖和氧化应激，这表明这两种疾病之间存在相互作用，可能会导致其他人类疾病的发生。有效的糖尿病管理应包括多方面的方法，不仅要控制血糖，还要控制血压和血脂。治疗方案应根据每个患者的需求个体化制定，应包括生活方式改变和药物治疗相结合，以实现最佳控制。随着新型抗糖尿病药物如钠-葡萄糖协同转运蛋白（SGLT）抑制剂和胰高血糖素样肽-1（GLP-1）受体激动剂的出现，在开始血糖控制治疗时，考虑它们降低血压、增强肾功能和降低心血管疾病风险的潜力至关重要。对这些疾病之间共同的潜在机制有更深入的理解，可能为开发创新的治疗方法来应对它们铺平道路。我们的综述对文献进行了深入分析，全面阐述了糖尿病-高血压合并症的潜在机制及其对心脏和肾脏疾病的影响。本文最后讨论了目前管理高血压糖尿病患者 的方法，以制定一套全面的个体化建议。
