This site is intended for healthcare professionals only

Managing hypertension in diabetes

Written by: | Published:

Treatment targets may need to be individualised in Treatment targets may need to be individualised in older patients to avoid side-effects such as postural hypotension

Hypertension is a well-recognised comorbidity in people with diabetes, with a prevalence up to three times greater than in those without diabetes. This association is particularly strong in type 2 diabetes, where activation of the renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system leads to vasoconstriction mediated by angiotensin II and catecholamines. A further contributor to hypertension generated by RAAS activation is aldosterone, which promotes sodium and hence water reabsorption osmotically.1

It has been estimated that the risk of myocardial infarction (MI) in people with diabetes without previous MI is equivalent to patients without diabetes who have already had an MI.2 Patients with both diabetes and hypertension have a cardiovascular (CV) risk approximately three times that of patients with either diabetes or hypertension alone.3 It seems clear that hypertension is a key factor in the predisposition of those with diabetes to MI. The combination of diabetes and hypertension also further increases the risk of stroke.3

The incidence of microvascular complications of retinopathy and nephropathy are also raised by this dual comorbidity, with a seven-fold higher risk of progression to end-stage renal disease if hypertension is present.1


Please login or register to read the rest of the article and to have access to downloads and comments.


What do you think? Leave a comment below or tweet your views to @IndyNurseMag

This material is protected by MA Healthcare Ltd copyright.
See Terms and Conditions.

Newsletter

Sign up to the newsletter

About

Independent Nurse is the professional resource for primary care and community nurses, providing clinical articles for practice nurses and prescribers.

Newsletter

Subscribe to our newsletter and stay up to date with the latest nursing news.

Stay Connected

Stay social with Independent Nurse by following us on Twitter, liking us on Facebook or connecting on LinkedIn.

Archive

Need access to some of our older articles? You can view our archive, or alternatively contact us.

Contact Us

MA Healthcare Ltd.
St Jude's Church, Dulwich Road
London, SE24 0PB

Tel: +44 (0)20 7738 5454
Registered in England and Wales No. 01878373

Meet the team

Authors

Find out how to contribute to Independent Nurse here.