Abstract
Hypertension, defined as blood pressure >= 140/90 mm Hg, is a very common comorbidity of diabetes mellitus, occurring in 20-60% of diabetics depending on age, ethnicity or presence of obesity, type of diabetes and duration of diabetes. In patients with type 1 diabetes, hypertension is usually due to kidney disease.
In contrast, arterial hypertension and type 2 diabetes are now considered to be different clinical manifestations of the metabolic syndrome, thus a consequence of insulin resistance. In up to 80% of cases, so-called essential hypertension precedes the manifestation of type 2 diabetes, in patients with type 2 diabetes, hypertension is more than twice as common as in unediabetics.
Hypertension has been shown to be associated with the early development of macrovascular complications, an increased incidence of heart failure, and the development and progression of microangiopathic complications (particularly diabetic neuropathy and retinopathy). The concomitant presence of hypertension and type 2 diabetes has serious consequences for the patient's prognosis, mortality from cardiovascular disease increases up to six times with the concomitant treatment of inconsistently treated hypertension and diabetes, and up to 35 times with proteinuria.