Hypertension and diabetes – malignant cardiometabolic combination

Česká verzia

Authors: Hana Rosolová
Authors place of work: Centrum preventivní kardiologie, II. interní klinika LF UK a FN Plzeň
Published in the journal: AtheroRev 2019; 4(2): 87-90
Category: Reviews

Kombinace diabetes mellitus (DM) a arteriální hypertenze (AH) postihuje 4–10 % populace a jejich společný výskyt narůstá s věkem. Tyto choroby nesou vysoké riziko pro výskyt makro- i mikrovaskuárních komplikací, tj. kardiovaskulárních nemocí na podkladě aterosklerózy a diabetické nefropatie, retinopatie a neuropatie. Obě nemoci jsou fenotypicky velmi heterogenní, ale rizikové faktory pro jejich vznik jsou podobné a mají původ v dnešním životním stylu a životním prostředí. Důležitým „mezistupněm“ v rozvoji AH a DM 2. typu (DM2T) je metabolický syndrom, jehož podkladem je inzulinová rezistence. Tento stav je reverzibilní, a proto je jeho ovlivnění v primární prevenci DM2T kruciální. Pokud je diagnostikován DM a AH, je třeba včas zahájit nefarmakologická opatření i vhodnou farmakologickou léčbu hypertenze, DM i dyslipidemie. Jsou uvedeny nejvhodnější léky a jejich kombinace podle současných evropských doporučení.

Summary

Combination of diabetes mellitus (DM) and arterial hypertension (AH) affects about 4–10% of population and their joint prevalence is increasing with age. Those diseases bring high risk of macro- and microvascular complications, i.e. atherosclerotic vascular diseases and diabetic nephropathy, retinopathy and neuropathy. The both diseases are heterogeneous in phenotype, but their risk factors are similar and are present in our life style and environment. Metabolic syndrome represents the interstage between AH and type 2 DM (T2DM) and insulin resistance is the background of it. Metabolic syndrome is reversible and therefore its influencing is crucial in primary prevention of T2DM. If AH and T2DM are diagnosed, to start very early non-pharmacological measures and pharmacotherapy for hypertension, diabetes and dyslipidemia are very important. The most appropriate drugs and their combination by the up to date European Guidelines are mentioned.

Keywords:

arterial hypertension – insulin resistance – management of hypertension in diabetics – prevention of macro- and microvascular complications

Zdroje

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