Diabetes and Hypertension

Abstract

Diabetic people are more prone to hypertension than those without this metabolic disorder (1–6). More than 3 million people in the United States have both type II diabetes and hypertension (1–3). Cardiovascular disease (CVD) is the largest cause of morbidity and mortality in diabetic persons with coexistent hypertension. Accordingly, a major focus of hypertension therapy for these persons should be the reduction of CVD morbidity and mortality, while reducing the complications of diabetic nephropathy. The causation of this comorbidity in Westernized societies may be attributed to populations getting older, more obese, and more sedentary (1–6). Up to 80% of the premature mortality in persons with this diabetes is due to CVD (1–6). Hypertension plays a key role in promoting CVD in diabetic persons (1–6). These observations have contributed to the recommendations of more aggressive lowering of blood pressure (BP) (i.e., to <130/85 mmHg) in people with both diabetes and hypertension (2–7). However, it appears that most of such persons are inadequately controlled at this desired BP (5,8). New strategies are being reviewed to improve our ability to reach BPs in this high-risk population.