Hypertension and type 2 diabetes: lights and shadows about causality
Journal of Human Hypertension, Published online: 21 October 2019; doi:10.1038/s41371-019-0268-xHypertension and type 2 diabetes: lights and shadows about causality
Conclusion The compliance to guidelines is overall well for patients with hypertension and coronary artery disease, but improvements is needed for patients with type 2 diabetes. Multi-center studies with large-scale data are required to further assess the usage of antihypertensive agents in patients.
Type 2 diabetes mellitus (T2DM) is a metabolic disease that, together with high blood pressure and other noncommunicable diseases (such as cardiovascular diseases), is among the leading causes of mortality in Latin America and the world [1 –2]. The frequency of T2DM is increasing worldwide, and its prevalence increases with age, exceeding 18% after 65 years of age [3–5]. T2DM is characterized by peripheral insulin resistance and a progressive deterioration of pancreatic β-cell function . Its treatment involves important lifest yle changes that include weight reduction, adequate physical activity, proper...
SGLT2 inhibitors are commonly used in the treatment of type 2 diabetes, but what do we know about the renal effects of these drugs?Current Opinion in Nephrology and Hypertension
Conclusion: Candidates for bariatric/metabolic surgery favored SG followed by AGB, GP, and RYGB, and their choices were compatible with current evidence-based clinical practice. PMID: 32051816 [PubMed]
Abstract Diabetic kidney disease is growing exponentially. This review aims to discuss alternate therapeutic approaches beyond the glomerulocentric view and to consider a novel tubulocentric approach with focus on the primary cilia. Renin-angiotensin-aldosterone system blockade to decrease glomerular capillary pressure and prevent albuminuria has been the mainstay of treatment for diabetic and non-diabetic proteinuric kidney disease. Landmark clinical trials have also shown cardiorenal benefit with sodium-glucose linked co-transporter 2 inhibitors and glucagon-like peptide 1 receptor analogues in patients with typ...
Obesity, a remarkably increased healthcare problem, accompanies with morbidities including type 2 diabetes mellitus (DM), hypertension, and cardiovascular diseases. Hypothalamic-pituitary-adrenal (HPA) axis alteration is thought to be effective on the background of obesity, even concomitant with DM and hypertension. We aimed to evaluate the negative feedback mechanism of the HPA axis via overnight 1 mg dexamethasone suppression test (DST) and the association of post-1mg DST cortisol level with DM and hypertension presence in obesity.
Conclusions: The development of a pheochromocytoma from an adrenal non functional adenoma is an extremely rare event, but potentially life-threating because of the catecholamine-associated cardiovascular toxicity. In particular, TTS is a form of cardiomyopathy that has been increasingly described as associated with catecholamine-secreting tumors. The exclusion of pheochromocytoma in a patient with TTS has important therapeutic implications, since the administration of β-blockers may be extremely harmful in patients with catecholamine surge in the absence of adequate α-blockage.
Patients with overnutrition, obesity, the atherometabolic syndrome, and type 2 diabetes typically develop fatty liver, atherogenic dyslipoproteinemia, hyperglycemia, and hypertension. These features share an unexplained origin – namely, imbalanced insulin action, also called pathway-selective insulin resistance and responsiveness. To control glycemia, these patients require hyperinsulinemia that then overdrives ERK and hepatic de-novo lipogenesis. We previously reported that NADPH oxidase-4 regulates balanced insulin ac tion, but the model appeared incomplete.
Conclusion The mediating effects of sleep improvement on cardiometabolic risk/disease control were inconclusive. More research to examine the effect of sleep-related risk-factor modification on cardiovascular health is warranted.
This study reports on the clinical, biochemical and genetic associations of MetS and its risk factors to improve individualized medicine outcomes. METHODS: There were 471 subjects included in this cross-sectional study, 367 with MetS and 104 without MetS. Along with clinical and laboratory parameters, multiple risk genetic variants were tested for their association with MetS, which include 49 variants that have previously been shown to be linked with MetS development as a phenotype, 116 variants for association with waist-hip ratio (WHR), 398 variants with body-mass index (BMI), 213 variants with T2DM and insulin resi...