Diabetes and hypertension are two of the most common chronic conditions worldwide, affecting millions of people. A diabetic person with hypertension has a 2 to 4 times greater risk of developing cardiovascular disease. compared to a normotensive diabetic person 1 .
Prevention in the ambit or cardiometabolic, especially in case of genetic predisposition, can significantly reduce the onset and/ or complications of diabetes .
Diabetes
Diabetes is a disease characterized by high levels of glucose in the blood ( hyperglycemia ) , due to an alteration in the quantity or mechanism of action of insulin. Insulin is the hormone produced by the β (beta) cells of the pancreas, which allows the entry of glucose into the cells and its subsequent use as an energy source. When there is an alteration of this mechanism an increase in blood glucose levels may occur , preventing its accumulation at the cellular level.
There are different forms of diabetes:
Type 1 diabetes : autoimmune in origin in which the body (mistakenly) attacks the pancreatic beta cells .
Type 2 Diabetes: It is a combination of reduced insulin secretion and insulin resistance, so that this, Although it is produced, it is not used satisfactorily. Overweight and obesity, particularly visceral obesity which correlates with alterations in glucose homeostasis, are conditions which, together with predisposing genetic factors, increase the risk of developing type 2 diabetes .
Gestational diabetes : This occurs during pregnancy and usually resolves after delivery, but increases the risk of developing type 2 diabetes later in life 2,3 .
Hypertension
Hypertension it's a pathology in which the resting blood pressure And persistently elevated. The reference values used to define hypertension are a systolic (maximum) pressure greater than 140 mmHg and a diastolic (minimum) pressure greater than 90 mmHg. During contraction, the heart generates a force , known as systolic blood pressure, which is essential to push blood through the arteries that deliver oxygen and nutrients to cells. After each beat, when the heart relaxes, the pressure reaches its lowest value, which is called diastolic pressure. With age or other external factors, such as stiffening of the arteries or an increase in blood viscosity, the heart is forced to exert more force to push the blood , thus leading to an increase in blood pressure.
A prolonged presence of this condition , in addition to exposure to risk factors, can lead to the onset of heart attacks, strokes , atherosclerosis, aneurysms, kidney damage , heart failure .
RISK FACTORS
Risk factors for diabetes and hypertension often overlap and include:
Genetics : Family history plays a significant role in both conditions.
Lifestyle : poor diet, lack of physical activity , Smoking , a sedentary lifestyle, and excessive alcohol consumption can contribute to the onset of diabetes and increased blood pressure, increasing overall cardiovascular risk.
Body weight : Obesity and being overweight are important risk factors, especially fat accumulated in the abdominal area (visceral adiposity).
Age : The risk increases with age. In the case of type 2 diabetes it increases especially after the age of 45 4.5 .
Psycho-physical stress : Chronic stress can affect blood pressure and raise blood sugar levels.
TIPS FOR MANAGING AND PREVENTING DIABETES AND HYPERTENSION
Adequate prevention and a healthy lifestyle play a crucial role in preventing and mitigating the symptoms of these diseases.
Medication Adherence : For those who have been prescribed medications, therapeutic adherence is a fundamental prerequisite for the success of any therapy, especially in chronic cases, to prevent complications and manage comorbidities.
Diet : adopt a balanced diet rich in fruit and vegetables (at least 5 portions a day); whole grains ; legumes and fish; prefer white meat to red meat and low-fat milk and dairy products; use extra virgin olive oil as seasoning and only occasionally consume sausages and pre-packaged products . Limit the consumption of highly processed foods and, in addition , the intake of sugars and foods high in sodium.
Physical exercise : Adopting an active lifestyle, with regular physical activity, plays a crucial role in weight control, reducing blood pressure and improving insulin sensitivity . exerting a protective effect on the development of type 2 diabetes mellitus. Aim for at least 150 -300 minutes of moderate aerobic activity or 75 -150 minutes of vigorous activity per week 6 .
Maintenance and/or reduction of body weight : there is a correlation between visceral adiposity and metabolic alterations, in particular with the onset of insulin resistance. Maintaining a healthy weight is essential to reducing the risk and managing these conditions. Even a modest weight loss can have a significant impact , in conditions of overweight/obese .
Regular monitoring : Monitor your blood pressure and blood glucose levels regularly to manage possible onset of diabetes and hypertension or progression of complications.
Stress Management : Chronic stress can lead to increased blood pressure through the production of stress hormones such as adrenaline and cortisol. These hormones cause an increase in heart rate and vasoconstriction , resulting in increased blood pressure .
REFERENCES
1. Jyotsna F, Ahmed A, Kumar K, Kaur P, Chaudhary MH, Kumar S, Khan E, Khanam B, Shah SU, Varrassi G, Khatri M, Kumar S, Kakadiya KA. Exploring the Complex Connection Between Diabetes and Cardiovascular Disease: Analyzing Approaches to Mitigate Cardiovascular Risk in Patients With Diabetes. Cureus . 2023 Aug 21;15(8 ):e 43882.
2.Nakshine VS, Jogdand SD. A Comprehensive Review of Gestational Diabetes Mellitus: Impacts on Maternal Health, Fetal Development, Childhood Outcomes, and Long-Term Treatment Strategies. Cureus . 2023 Oct 23;15(10 ):e 47500.
3. Anderberg E, Landin-Olsson M, Kalén J, Frid A, Ursing D, Berntorp K. Prevalence of impaired glucose tolerance and diabetes after gestational diabetes mellitus comparing different cut-off criteria for abnormal glucose tolerance during pregnancy. Acta Obstet Gynecol Scand. 2011 Nov;90(11):1252-8.
4. Goyal R, Singhal M, Jialal I. Type 2 Diabetes. [Updated 2023 Jun 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
5. Rauseo A, Pacilli A, Palena A, De Cosmo SA. Management of type 2 diabetes in geriatric patients. J Nephrol. 2010 Sep-Oct;23 Suppl 15:S 72-9.
6. WHO guidelines on physical activity and sedentary behavior r , 2020
