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ABSTRACT
Arterial hypertension and diabetes
mellitus are powerful and independent risk factors for development
of blood vessels disease (coronary, cerebro-vascular and peripherial
diseases), as well as kidney disease. Simultaneous motion of hypertenson
and diabetes mellitus does not essentialy represent the risk factor
calculation; moreover, it represents serious condition of exponentially
increased risk.
HTA (hypertension) is two times more likely to occur in patients
with Diaebetes mellitus (DM), and is often coupled with diabetes
nephropathy. HTA incidence in DM type II is higher (67 %), than
in DM type I and is often registered at the time when diagnosis
for DM type II is established (patophysiological nature of developing
manifestable DM type II begins about 12 years before it is diagnosed).
Rationale for HTA occurence in DM is: genetic predisposal, endothelial
dysfunction, insulin resitance and number of other surrounding factors.
The goal of HTA therapy in DM is to prevent death, specific morbidity
and invalidity, yet not to deteriorate glycoregulation, lyporegulation
and chronic complications (peripheral, microangiopathy, nephropathy,
etc.). HTA therapy in DM recommend the engagement of pharmacological
and non-pharmacological measures that can be implemented in accordance
with "step by step" principle, and it conceives very complex therapy.
Pharmacological characteristics of antihypertensives have to be
taken into consideration, as well as other potential side effect
diseases. The aimed value is less than 130/80 mm Hg (JNC). As the
first step the therapy suggest the use of medicaments from „the
front line antyhypertesives“ ACE inhibitors or cardioselected b-adrenergic
blockers, calcium channel blockers, and in case the retntion of
natrium and water appears, the diuretics are added (only small doses).
Uncured hypertension in Diabetes Mellitus highly increases the risk
for develloping of chronic macro- and microangiopathic complications.
Keywords: arterial hypertension, diabetes, endothelial dysfunction
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