Hypertension and diabetes show a strong epidemiologic association. About
75% of adults with diabetes have blood pressure levels =130/80 mmHg or
use antihypertensive medication and this percentage goes up to 90% if
microalbuminuria is also present. On the other hand, individuals with
hypertension are 2.5 times more likely to develop diabetes within 5
years of diagnosis. The presence of hypertension in patients with
diabetes substantially increases the risk for both cardiovascular and
renal diseases and is associated with a 7.2-fold increase in mortality,
whereas in those with diabetes and diabetic nephropathy, hypertension
causes a 37-fold increase in mortality.
Hypertension in type 1 diabetes generally results from the underlying
nephropathy and in type 2 diabetes it usually occurs in the context of
the cardio- metabolic syndrome. Understanding the pathophysiological
context and the overall cardiovascular risk assessment together with the
current therapeutic modalities for people with diabetes and hypertension
is a sine qua non for effective management of this growing patient
population.
In this book we present to the primary care providers as well as to the
sub-specialists an integrative approach to hypertension and diabetes
including lifestyle and pharmacological approaches, focusing on overall
cardiovascular risk reduction with special emphasis on high- risk
population. We also provide an overview of the preventive measures for
both hypertension and diabetes in the light of the most recent clinical
trials. Finally, we discuss the future outlook for the epidemic and the
ongoing clinical studies together with the various innovative diagnostic
modalities.
