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Friday, 26.04.2024, 03:36
Main » Cardiology » Diabetes mellitus and hypertension 
17:37
Diabetes mellitus and hypertension


Diabetes mellitus and hypertension

Hypertension - an important risk factor for serious complications of diabetes


Hypertension is an important risk factor for many serious complications of diabetes and worsening its course, including diabetic retinopathy, nephropathy, micro-and macroangiopathy.

Diabetes itself is also a predisposing factor for hypertension, as observed in this disease of the arteries and damage, particularly of small arteries - arterioles, which promotes the deposition of atherosclerotic plaques in them. In turn, atherosclerosis in the absence of proper attention to it, and adequate treatment can significantly increase the risk of hypertension and coronary heart disease (in the form of angina and myocardial infarction) and strokes. In addition, atherosclerosis and kidney damage observed.

Diabetic retinopathy

This is a condition in which the observed narrowing of the small arteries of the retina. It is caused by lesions of the arteries of small caliber, which is very characteristic of diabetes. Atherosclerosis and high blood pressure, which contribute to a narrowing of the lumen of these arteries are further aggravating the situation.

Retin-A - is the most important element of the eye responsible for vision. If you are currently corneas, and even such a fragile part of the eye as the lens can simply be replaced by the operation, we do this with the retina is not yet possible. Laser surgery, which are now performed on the retina, and not always effective, and in severe cases, the effect of them is unlikely.

Diabetic nephropathy

The term "nephropathy" is indicated renal failure due to an illness. In diabetic nephropathy, as well as with retinopathy, the main mechanism - the defeat of the arteries of small caliber. In fact, while suffering the vessels of kidney glomerular apparatus, which is responsible for the filtration of plasma and urine. In diabetic nephropathy, renal failure observed phenomenon, since there is a violation of the filtration function of the kidneys. Hypertension aggravates during diabetic nephropathy, as it promotes further narrowing of the arteries in the kidneys and the disruption of blood flow in them.

Micro-and macrovascular


These terms refer to the pathology of the arteries of small and large caliber, respectively. In diabetes increases the risk of deposition of atheromatous plaques in the walls of the aorta and large arteries that can lead to a narrowing of the lumen. One manifestation of this is the so-called Leriche syndrome, which is marked narrowing of the abdominal aorta in the region of its bifurcation (splitting), which formed the iliac artery. As a result, broken blood vessels in the legs. There is lameness, muscle weakness of lower limbs, and most importantly - pain when walking.

Diabetic macroangiopathy mikroagniopatiya accompanied by, and represents a loss of small arteries, mainly the extremities. Most often suffer from the toes that is caused by the test of load. In the absence of proper treatment or its inefficiency may be a terrible complication, as the diabetic foot, which is marked gangrene of the tissues of the foot. And this is a complication with his ineffective treatment, can quickly lead to amputation of the foot.

Effect of hypertension on the course of diabetes

If hypertension is marked increase in the risk of these complications of diabetes. This is due to the fact that hypertension is marked narrowing of the arteries, and in addition, the propensity to develop atherosclerosis.

It is therefore important for patients with diabetes control their blood pressure. If you have identified diabetes mellitus, and you successfully manage to control it with medication, the need for regular blood pressure measurements are not eliminated.

Treatment

Patients with diabetes mellitus and arterial hypertension is most often prescribed ACE inhibitors. These drugs include Capoten, enam, enam, lisinopril, and many others. Their effect is that they hinder the work of an enzyme that is responsible for the formation of angiotensin - a substance that is converted further to renin. A renin, as we know, has the property of narrow blood vessels and increase the PD. Renin is produced by cells of kidney juxtaglomerular apparatus. Therefore, ACE inhibitors are particularly useful in diabetes, which is accompanied by diabetic nephropathy.

Note: Some drugs for hypertension may increase blood sugar levels, so before you apply any self-medication, consult with your physician or endocrinologist.

In addition, it was noted that some drugs may be more effective in certain groups of patients. For example, diuretics are effective in older patients and patients with hypertension, salt-sensitive reception.

Diuretics are also used for the treatment of hypertension and diabetes mellitus patients. As for the adequate treatment of hypertension often requires taking multiple medications, doctors usually prescribe ACE inhibitors first, and then add other antihypertensive agents.

What is the prevention of increasing blood pressure in diabetes

Patients with diabetes for the prevention of hypertension, and diabetes complications, we recommend:
  • Immediately quit smoking,
  • Follow a diet prescribed by a dietitian,
  • Maintain a healthy body weight,
  • Physical exercise,
  • Limit the use of salt.





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