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Review
. 2014 Mar;43(1):103-22.
doi: 10.1016/j.ecl.2013.09.005. Epub 2013 Dec 12.

Type 2 diabetes mellitus and hypertension: an update

Guido Lastra  1 , Sofia Syed  2 , L Romayne Kurukulasuriya  3 , Camila Manrique  1 , James R Sowers  4
Affiliations
Review

Type 2 diabetes mellitus and hypertension: an update

Guido Lastra et al. Endocrinol Metab Clin North Am. 2014 Mar.

Abstract

Patients with hypertension and type 2 diabetes are at increased risk of cardiovascular and chronic renal disease. Factors involved in the pathogenesis of both hypertension and type 2 diabetes include inappropriate activation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, impaired insulin-mediated vasodilatation, augmented sympathetic nervous system activation, altered innate and adaptive immunity, and abnormal sodium processing by the kidney. The renin-angiotensin-aldosterone system blockade is a key therapeutic strategy in the treatment of hypertension in type 2 diabetes. Emerging therapies for resistant hypertension as often exists in patients with diabetes, include renal denervation and carotid body denervation.

Keywords: Cardiovascular disease; Chronic kidney disease; Diabetes; Hypertension; Renin-angiotensin-aldosterone system; Sympathetic nervous system.

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Figures

Figure 1
Figure 1
Systemic and metabolic factors that promote coexistent diabetes mellitus, hypertension, cardiovascular, and chronic kidney disease. Adapted from Sowers JR. Recent Advances in Hypertension. J Am Heart Assoc 2013;61: 943-947; with permission.
See this image and copyright information in PMC

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