Journal article
Mechanisms and pharmacotherapy of hypertension associated with type 2 diabetes
Biochemical pharmacology, Vol.206, 115304
12/2022
DOI: 10.1016/j.bcp.2022.115304
PMID: 36341939
Abstract
The interacting risk factors/disease mechanisms that drive the pathogenesis of hypertension and co-morbid Type 2 Diabetes Mellitus that ultimately lead to both micro/macrovascular complications. Also, presented are evidence-based treatments with shown cardiovascular benefit that may help halt micro/macrovascular complications of Type 2 Diabetes and Hypertension. The “Western Diet” is characterized by a diet high in saturated fats, sodium, and refined carbohydrates and low in fiber, fruits, vegetables, and whole grains. Abbreviations: AGE/RAGE, advanced glycation end-products/receptor for advanced glycation end-products; IL6, interleukin-6; miRNA, microRNA; miRNA-155, microRNA-155; NO, nitric oxide; OSA, obstructive sleep apnea; RAAS, renin-angiotensin-aldosterone system; SNS, sympathetic nervous system.
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Type 2 diabetes is often complicated with hypertension, such that 73.6 % of patients ≥ 18 years with type 2 diabetes also have hypertension. With increasing age, the risk of developing these conditions rises significantly. Co-existence of type 2 diabetes and hypertension suggests that there are overlapping genetic, physiologic, and environmental factors at play. Research has shown several overlying metabolic abnormalities including sympathetic nervous system overactivation, insulin resistance, inflammatory and endothelial dysfunction, deleterious expression of microRNAs, and obstructive sleep apnea. Though diet and physical activity are the mainstays of treatment early in the disease course, they are generally not a viable long-term strategy. Treatment with novel hypoglycemic and anti-hypertensive medications can greatly assist in preventing long-term complications of these chronic conditions. Recognition of the common causes and consequences of type 2 diabetes and comorbid hypertension allows for a robust response towards being proactive regarding prevention and treatment of this unique patient population. Thus, the purpose of this current review is four-part: to (1) review the latest discoveries into the mechanisms of hypertension in the setting of type 2 diabetes, (2) discuss the latest treatments of hypertension with a brief discussion about novel hypoglycemic agents in patients with type 2 diabetes, (3) summarize blood pressure targets and (4) to address evidence gaps in treating patients with diabetes and resistant hypertension, and elderly individuals with both hypertension and diabetes.
Details
- Title: Subtitle
- Mechanisms and pharmacotherapy of hypertension associated with type 2 diabetes
- Creators
- Vijayvardhan Kamalumpundi - University of IowaElham Shams - University of IowaCally Tucker - Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United StatesLinhai Cheng - University of IowaJoshua Peterson - Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United StatesSanmati Thangavel - University of IowaOloigbe Ofori - Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United StatesMarcelo Correia - Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Biochemical pharmacology, Vol.206, 115304
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.bcp.2022.115304
- PMID
- 36341939
- ISSN
- 0006-2952
- eISSN
- 1873-2968
- Language
- English
- Date published
- 12/2022
- Academic Unit
- Endocrinology and Metabolism; Internal Medicine
- Record Identifier
- 9984359839602771
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