The Health Significance Of The Optimal Management Of The Hypertensive Diabetic Patient

Funom Makama By Funom Makama, 21st Mar 2014 | Follow this author | RSS Feed
Posted in Wikinut>Health>General Health>Diseases & Infections

Both hypertension and diabetes are chronic non communicable diseases, often asymptomatic at the early stages and play a significant role in the morbidity and mortality in the present decease. They are both independent risk factors for cardiovascular disease when they co-exist; they are synergistic in this effort. There is a temporal relationship between hypertension and diabetes as they often occur together.

Hypertension And Diabetes

Hypertension in the diabetic patient markedly heightens the risk of end stage renal disease, coronary artery disease and diabetic retinopathy. Importantly, control of blood glucose alone is not enough to optimally reduce the incidence of diabetes-related mortality of myocardial infarction in the hypertensive diabetic patient. Treatment of the co-existing hypertension is also important.

About 70% of diabetics are hypertensive. Patients with diabetes may have a defective ability to feel angina or heart pain, and instead, they may have shortness of breath or unexplained sweating or fatigue. And those symptoms could represent heart disease, but because they are not classical symptoms, they often don’t get reported and consequently, not regarded as heart disease. They may have pain in the right shoulder instead of left shoulder.

Insulin resistance or syndrome X: This is a reduced sensitivity to the action of insulin. It is a cluster of risk factors and its clinical manifestations include central obesity, hypertension, glucose intolerance or type 2 diabetes, acnthosis nigricans, artherosclerosis, dyslipidemia and vascular abnormalities. Insulin resistance can lead to accelerated vascular disease.

Optimal Management

The following measures are very important in the optimal management:
• Medical history especially nutrition, weight history, health beliefs, family history of diabetes and hypertension, cigarette smoking and alcohol consumption, symptoms related to eyes, kidney, heart, nerves and feet, reproductive and sexual history.
Physical examination: General assessment including height and weight (to determine BMI), accurate blood pressure determination, cardiac abdominal, thyroid, feet, neurological examination and fundoscopy (eye examination).
Laboratory examination: Fasting blood glucose, lipid profile serum creatinine, total cholesterol, LDL, HDL, triglycerides, ECG, urinalysis for ketones, proteins and sediments.

Due to the connection between diabetes and heart disease, the American Heart Association in 1999 came out with the statement: “Diabetes is a Cardiovascular Disease”. In fact, United Kingdom prospective study found out that 1/3 of diabetics has some form of vascular diseases.

Diabetes and hypertension are silent killers because they do not give symptoms at the early stages and when not managed optimally, they may give rise to complications like heart diseases leading to death, stroke, eye diseases and blindness, complications of pregnancy and psychosocial complications. In addition, diabetes can lead to skin and dental problems, neuropathy, feet amputations and coma.

Lifestyle Measures: Stop smoking, control weight to within a BMI of 18.5 to 25; increase physical activity, reduce salt intake, moderate alcohol intake and reduce stress.

For more interesting and very important health related and medical articles, click on the links below
1. General Considerations, Clinical And Medical Classifications Of Anemia
2. Heart Failure: Definition, Detailed Causes And Precipitating Factors Of Cardiac Failure
3. Special Investigations In Cardiology II: The Significance Of Echocardiography
4. Clinical Significance And Health Importance On The Actions Of Adrenocorticotropic Hormone (ACTH) On The Adrenal Cortex

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Comments

author avatar Lambasted
25th Mar 2014 (#)

As usual, one of your excellent stuff you have shown to us.. Keep it up Dr. Funom

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