Obesity hypertension | Why does diabetes cause high blood pressure(2)

How to judge whether you have diabetes and high blood pressure?

In patients with type 1 diabetes and kidney disease, the cause of hypertension is usually renal. Therefore, most patients do not need to make detailed identification if there are no other clinical abnormalities. In patients with type 2 diabetes who have proteinuria, hypertension can be renal, or it can be present before most patients develop kidney disease. Kidney disease is the cause of the further deterioration of high blood pressure. According to clinical symptoms, hypertension caused by other causes should be further identified.

1. The symptoms of diabetes itself

The symptoms may be atypical or have characteristic changes such as polydipsia, polyuria, polyphagia, fatigue, drowsiness, weight loss, and corresponding manifestations of diabetes with other complications.

2. Symptoms of hypertension

In the early stage, there may be asymptomatic or headache, dizziness, blurred vision, vertigo, loss of appetite, tinnitus, insomnia, etc. Symptoms and blood pressure levels may not be consistent. Physical examination may have aortic second heart sound hypertrophy, long-term hypertension may show signs of left ventricular hypertrophy.

3. Specific symptoms of diabetes and hypertension

①Supine hypertension with orthostatic hypotension: Diabetic patients with autonomic neuropathy are prone to normal or elevated supine blood pressure with decreased blood pressure in the upright position. Maintaining orthostatic blood pressure requires a combination of cardiac output, effective circulatory volume, and baroreceptor reflex activation of various vasoactive hormones. If any link in this mechanism is abnormal, orthostatic hypotension may occur. One or more of the above-mentioned link disorders may occur in diabetes, which cannot be effectively compensated, resulting in orthostatic hypotension;
②Hypertension with low renin or normal renin: plasma renin activity in diabetic patients without nephropathy is mostly normal or a small part is low renin activity. When combined with more severe nephropathy, low renin, low angiotensin, and Changes in low aldosterone.

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