What is the reason of diabetic high blood pressure
summary
Diabetes is very common in our life. We can eat more light food. Diabetic hypertension is one of the complications of diabetes, which is harmful. Many patients don't know why diabetes is associated with hypertension? What causes diabetes and hypertension? Let's take a look at the following introduction.
What is the reason of diabetic high blood pressure
First: factors that cause hypertension in diabetes: type 2 diabetes, the mechanism of hypertension is related to * sodium retention and increased vascular resistance. If hypertension occurs before diabetes, it is mostly primary hypertension; if hypertension occurs in the course of diabetes, there are three possibilities: primary hypertension, systolic hypertension caused by atherosclerosis, renal hypertension caused by diabetic nephropathy. In type 1 diabetes, the majority of hypertension is renal hypertension caused by diabetic nephropathy. * water and sodium retention are the main mechanisms, which often occur after microalbuminuria. The mechanism of diabetes mellitus with hypertension is still not fully understood. Hyperglycemia itself inhibits the relaxation of vascular endothelium, increases intracellular free calcium, and stimulates the transcription of growth factor gene in vascular smooth muscle.
Second: hyperinsulinemia. Type 2 diabetes has hyperinsulinemia due to insulin resistance. Type 1 diabetes can also lead to hyperinsulinemia due to long-term large amount of exogenous insulin. Hyperinsulinemia can lead to hypertension through the following factors: ① increasing renal sodium and water reabsorption; ② increasing the sensitivity of blood pressure to salt intake; ③ increasing the sensitivity of vasopressin and aldosterone to angiotensin II; ④ changing electrolyte transmembrane transport, which is characterized by increased intracellular sodium transport, decreased Na-K-ATPase activity, and increased na-h-atpase activity; ⑤ increasing intracellular calcium; and; ⑥ It can stimulate the expression of growth factor (especially the growth factor of vascular smooth muscle); it can stimulate the activity of sympathetic nerve; it can reduce the synthesis of vasodilator prostaglandin; it can increase the secretion of endothelin; it can damage the natriuretic effect of atrial natriuretic peptide. These * effects result in increased sodium, water retention and vascular tension, resulting in hypertension. In addition, it has been found that intracellular free magnesium level is negatively correlated with plasma insulin level, that is, hyperinsulinemia is accompanied by intracellular low magnesium, while intracellular magnesium level is negatively correlated with blood pressure.
Third: renin angiotensin aldosterone system in diabetic patients due to hyperinsulinemia, repeated water and salt metabolism disorders (such as ketoacidosis) and poor long-term metabolic control, can lead to repeated increase of renin angiotensin aldosterone system activity in vivo, which may be related to the occurrence of hypertension in diabetic patients. But in patients with diabetes mellitus complicated with renal disease and azoosemia, the renin angiotensin aldosterone system is inhibited, regardless of whether there is hypertension or not. It may be due to water and sodium retention, glomerular cell degeneration, sympathetic nerve activity * deficiency and renal prostaglandin deficiency.
matters needing attention
Diabetes combined with hypertension is very harmful to the body. For example, diabetes is often accompanied by fundus neuropathy, arteriosclerosis, heart, brain and kidney damage, and hypertension is also closely related to these lesions; the risk of vascular injury and sclerosis in patients with diabetes and hypertension is twice that in patients with simple hypertension, and cardiovascular disease is a risk factor for myocardial infarction and stroke.
