saw a video with drs talking about their patients . and they said all their patients with diabetes had high blood pressure as well . is this the case with you and do you think long term hbp… can cause db. or can db cause hbp…
any thoughts . but it seems hbp. is easyer to get down in my case anyway. and which one is more dangerous.
Some choice quotes from “Diabetes and Hypertension: Is There a Common Metabolic Pathway?”, a 2012 paper published in a medical journa. Complete article here: Diabetes and Hypertension: Is There a Common Metabolic Pathway? - PMC
“There is substantial overlap between diabetes and hypertension in etiology and disease mechanisms. Obesity, inflammation, oxidative stress, and insulin resistance are thought to be the common pathways.”
" In the US population, hypertension occurs in approximately 30% of patients with type 1 diabetes and in 50% to 80% of patients with type 2 diabetes"
“This suggests either shared genetic or environmental factors in the etiology.”
That last quote is I think the most powerful. It says it’s not necessary that diabetes cause high blood pressure or the other way around. It genuinely appears that they often both have the same root causes.
It is also true, that many of the complications of diabetes have even further increased risk if blood pressure is elevated. This is especially clear in the case of microvascular complications - for example, high blood pressure by itself can be a cause of retinopathy without diabetes even being present. Very similar for kidney disease.
There is some indication that high average blood sugars are themselves a cause of high blood pressure. For example in the DCCT the non-intensive group developed hypertension at 24% greater rate than the intensive group. At same time, the blood pressure results from DCCT show a much weaker connection between hypertension rate and A1C, than they show for microvascular complications like retinopathy. This really convinces me that there is a very real increased risk for high blood pressure even if bg’s/A1C’s are very well controlled.
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The high blood pressure feedback loop is especially interesting in the case of diabetic kidney disease, since while diabetes and its damage to the vascular system can increase blood pressure and damage the kidneys, damaged kidneys through the renin-angiotensin system cause an increase in blood pressure, which in turn worsens the condition of the kidneys.
The good news, if you can call it that, is that as the years of diabetes accumulate and neuropathy worsens, eventually autonomic neuropathy will cause the blood pressure to sink, so that some type 1 patients even require blood-pressure-boosting medications to keep from fainting when they stand up.
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