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Diabetes And Hypertension-Common Soil Hypothesis 41

sive in diabetics. It has renal protective effect in in- CONCLUSION
cipient nephropathy, reduce insulin resistance and Diabetes mellitus and hypertension are comorbid ill-
may improve glycemia in diabetics and patients nesses,in both developing and developed countries.
with the metabolic syndrome.
The presence of one increases the risk of having the
- Why ACEI is Preferred in DM ? other. Both increase the risk of cardiovascular and
- Improves insulin sensitivity renal disease. Every diabetes patient need measuring
- Reverse vascular and ventricular remodeling of blood pressure in every visit. Hypertensive patients
- Reverse LVH need to be screened for diabetes regularly. HBPM
- Cardio protection could be an ideal way in monitoring BP in hyperten-
- Renal protection sive patients in general and diabetic patients in par-
- Favorable glucose lipid metabolism ticular to ensure that the patient does not progress
to develop cardiovascular and renal complications.
- Thiazide diuretics and beta-blockers have meta-
bolic side-effects such as increasing insulin resis- REFERENCE
tance or direct diabetogenesis, which make them
less appropriate as first line agents 1. Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in de-
veloping countries. Circulation. 1998;97: 596 601.
- The use of CCBs was not significantly associated 2. Nabil K Elnaggar,Diabetes and Hypertension: J Hypertens 2014,Volume
with incident diabetes compared to other antihy- 3 • Issue 6 :page no 3:6
pertensive agents: the association with diabetes 3. Michael J. Cryer, MD; Tariq Horani, MD; Donald J. DiPette, MD:Dia-
was lowest for ACEIs and ARBs, followed by CCBs, betes and Hypertension: A Comparative Review of Current Guidelines:
β blockers, and diuretics. J ClinHypertens (Greenwich). 2016;18:page no;95–100.
4. Deepak Bharati, Savita Tauro:Diabetes with Hypertension: Etiology,
Effects of anti-diabetics on blood pressure Pathogenesis and Management:Int. J. Integrative Science. Inn. Tech.
Vol. IV, Issue4 pg 7 – 14
- The anti-diabetic agents involve their antidiabetic
actions which can be related to side actions where 5. Ehud grossman, MD- Ambulatory Blood Pressure Monitoring in the Di-
agnosis and Management of Hypertension diabetes care, volume 36,
changes of blood pressure subsequently occurs. supplement 2, AUGUST 2013
- Insulin causes salt and water retention, increases 6. Cristiane BauermannLeitão, Luís Henrique Canani, Sandra PinhoSilveiro,
body weight and it causes growth of tissues as an Jorge Luiz Gros: Ambulatory Blood Pressure Monitoring and Type 2 Di-
anabolic hormone abetes Mellitus: Arq Bras Cardiol 2007; 88(2): 315-321
- SGLT-2 inhibitors cause osmotic diuresis leading
to blood pressure reduction
- GLP-1 agonists and DPP-4 inhibitors have been
demonstrated to exert their effects directly through
the activation of their receptors on the cardiac and
vascular tissues or centrally positioned receptors
to reduce the blood pressure.

Effects of the different anti-diabetic drugs on
blood pressure
Drug Class Effect on Blood Pressure
Insulins Small increases
GLP-1 agonists Reduce blood pressure
SGLT-2 inhibitors Reduce blood pressure
DPP-4 inhibitors Small reductions
Biguanides (metformin) No effect
Sulphonylureas and No effect
Glinides
Amylin mimetics No effect
Table:2

Cardio Diabetes Medicine