Blood Pressure in Diabetes Mellitus

Etiology and Prevalence of Hypertension in Diabetic Patients

“…Several studies from the early years of this century suggested that the prevalence of hypertension was increased in patients with diabetes compared with nondiabetic subjects (1)(2)(3)(4)(5)(6). In his review of the literature in 1929, Major (1) identified at least 12 reports that addressed this relationship, and he concluded that the most consistent abnormality observed was an elevation of the systolic blood pressure in older diabetic patients.…”

“…In a large series from the Joslin Clinic in 1936, Root and Sharkey (4) reported that -5 0 % of patients with diabetes have an abnormally elevated blood pressure. However, these older studies suffered from many problems with experimental design or lack of appropriate controls (1)(2)(3)(4)6). The confounding effects of obesity (2,3), age (2,3), family history (1)(2)(3)(4)(5)(6), and other risk factors for hypertension were frequently not controlled.…”

“…However, these older studies suffered from many problems with experimental design or lack of appropriate controls (1)(2)(3)(4)6). The confounding effects of obesity (2,3), age (2,3), family history (1)(2)(3)(4)(5)(6), and other risk factors for hypertension were frequently not controlled. The diabetic populations often included a mixture of insulindependent (IDDM) and non-insulin-dependent (NIDDM) diabetic patients (1)(2)(3)(4)(5)(6), and the presence or absence of diabetic nephropathy was often not reported (1)(2)(3)5,6).…”

“…The confounding effects of obesity (2,3), age (2,3), family history (1)(2)(3)(4)(5)(6), and other risk factors for hypertension were frequently not controlled. The diabetic populations often included a mixture of insulindependent (IDDM) and non-insulin-dependent (NIDDM) diabetic patients (1)(2)(3)(4)(5)(6), and the presence or absence of diabetic nephropathy was often not reported (1)(2)(3)5,6). In addition, the criteria for defining hypertension and the methods for obtaining blood pressure determinations were not uniform among the various studies.…”

“…Physicians whose primary area of investigation was hypertension observed a high frequency of diabetes or abnormal glucose tolerance among their hypertensive patients and suggested that hypertension was a prediabetic state (1-3). Conversely, diabetologists focused their attention on the high prevalence of hypertension in their patient populations and its potential adverse effects on the long-term microvascular and macrovascular complications of diabetes (1,4). More recently, these two avenues of investigation have converged in an attempt to identify a unifying pathophysiologic basis for both diseases.…”