Petrie, J. R. , Guzik, T. J. and Touyz, R. M. (2018) Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Canadian Journal of Cardiology, 34(5), pp. 575-584. (doi: 10.1016/j.cjca.2017.12.005) (PMID:29459239) (PMCID:PMC5953551)
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Abstract
Hypertension and type 2 diabetes are common comorbidities. Hypertension is twice as frequent in patients with diabetes compared with those who do not have diabetes. Moreover, patients with hypertension often exhibit insulin resistance and are at greater risk of diabetes developing than are normotensive individuals. The major cause of morbidity and mortality in diabetes is cardiovascular disease, which is exacerbated by hypertension. Accordingly, diabetes and hypertension are closely interlinked because of similar risk factors, such as endothelial dysfunction, vascular inflammation, arterial remodelling, atherosclerosis, dyslipidemia, and obesity. There is also substantial overlap in the cardiovascular complications of diabetes and hypertension related primarily to microvascular and macrovascular disease. Common mechanisms, such as upregulation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, and activation of the immune system likely contribute to the close relationship between diabetes and hypertension. In this article we discuss diabetes and hypertension as comorbidities and discuss the pathophysiological features of vascular complications associated with these conditions. We also highlight some vascular mechanisms that predispose to both conditions, focusing on advanced glycation end products, oxidative stress, inflammation, the immune system, and microRNAs. Finally, we provide some insights into current therapies targeting diabetes and cardiovascular complications and introduce some new agents that may have vasoprotective therapeutic potential in diabetes.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Guzik, Professor Tomasz and Touyz, Professor Rhian and Petrie, Professor John |
Authors: | Petrie, J. R., Guzik, T. J., and Touyz, R. M. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
Journal Name: | Canadian Journal of Cardiology |
Publisher: | Elsevier |
ISSN: | 0828-282X |
ISSN (Online): | 1916-7075 |
Published Online: | 11 December 2017 |
Copyright Holders: | Copyright © 2017 Canadian Cardiovascular Society |
First Published: | First published in Canadian Journal of Cardiology 34(5):575-584 |
Publisher Policy: | Reproduced under a Creative Commons License |
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