The association between diabetes and hypertension: An overview of its clinical impact

Hypertension and diabetes have major adverse impacts on cardiovascular and renal disease, and often, these diseases can be found in the same individual. This paper reviews the available data on the high prevalence of the association between hypertension and diabetes. It then shows that this association leads to a marked increase in the risk of many events due to the damage to the microvasculature and macrovasculature that is caused by either high blood pressure or impaired glucose metabolism. Finally, the article focuses on how to treat patients with both diabetes and hypertension. Of note, neither risk factor is irreversible; ie, a reduction in blood pressure or blood glucose has a protective effect on the above-mentioned complications, and, although some differences between different drugs or treatment strategies exist, the benefits appear to be largely related to lowering blood pressure or blood glucose per se regardless of how it is obtained. In both cases, therapeutic success is not easy, as the target systolic blood pressure values recommended by most guidelines are usually reached with a combination of antihypertensive drugs, which should include a renin-angiotensin system blocker to enhance the protective effect of treatment on the kidney.