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Diabetes Complications, Comorbidities and Related Disorders pp 1–22Cite as

Hypertension and Diabetes

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Part of the book series: Endocrinology ((ENDOCR))

Abstract

Hypertension is seen in most people with hypertension and accentuates cardiovascular risk and accelerates development of kidney function decline. In most cases there is a genetic predisposition to develop hypertension in people with diabetes compounded by the presence of obesity and high sodium intake. While reduction in weight and sodium intake ameliorates elevations in blood pressure in most cases medications are needed. With proper control of blood pressure to levels below 140/90 mmHg there has been a marked reduction cardiovascular events and a slowing of kidney disease progression from 10–12 ml/min/year before decline in estimated glomerular filtration rate before 1985 to 2–4 ml/min/year decline currently. Moreover, those born after 1980 with type 1 diabetes have a 40% lower risk of developing end stage kidney disease than those born previously. Treatment of hypertension depends on stage of kidney disease. A low sodium i.e., <2300 mg/d diet, at least 6–7 hours of uninterrupted sleep and weight loss are the cornerstones of therapy. Drug treatment will be much less effective if these lifestyle issues are not in place. Those with macroalbuminuria i.e., greater than 300 mg/day and a blood pressure ≥ 140/90 mmHg must be treated if with an angiotensin converting enzyme inhibitor or an angiotensin converting enzyme inhibitor as part of the regimen. In all others it is important to lower blood pressure to <140/90 mmHg and use of either a renin angiotensin system blocker, thiazide-type diuretic or calcium antagonist may be used alone or in combination.

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Authors and Affiliations

  1. ASH Comprehensive Hypertension Center, Section of Endocrinology, Diabetes and Metabolism, The University of Chicago Medicine, Chicago, IL, USA

    Colleen Majewski & George L. Bakris

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  1. Colleen Majewski
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  2. George L. Bakris
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Correspondence to George L. Bakris .

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Editors and Affiliations

  1. Endocrinology, Diabetes and Metabolism, University of Verona, Verona, Italy

    Enzo Bonora

  2. Diabetes Division, UTHSCSA, San Antonio, Texas, USA

    Ralph DeFronzo

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Majewski, C., Bakris, G.L. (2018). Hypertension and Diabetes. In: Bonora, E., DeFronzo, R. (eds) Diabetes Complications, Comorbidities and Related Disorders. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-27316-7_5-1

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  • DOI: https://doi.org/10.1007/978-3-319-27316-7_5-1

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  1. Latest

    Hypertension and Diabetes
    Published:
    02 August 2019

    DOI: https://doi.org/10.1007/978-3-319-27316-7_5-2

  2. Original

    Hypertension and Diabetes
    Published:
    08 March 2018

    DOI: https://doi.org/10.1007/978-3-319-27316-7_5-1

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