What is the frequency of hypertension in DM

Hypertension constitutes a frequent problem among diabetic patients. Its frequency differs, however, between Type 1 and Type 2 DM.

Specifically, in Type 1 DM the frequency of hypertension increases with the duration of the disease and has a direct relationship to the appearance of nephropathy in these patients. Hypertension is relatively unknown in patients without nephropathy, and the coexistence of nephropathy and hypertension appears to worsen both conditions. Thus, the incidence of hypertension increases from 5 percent for duration of DM of 10 years, to 33 percent for duration of 20 years and 70 percent for duration of 40 years. Blood pressure begins to increase in these patients (even within the considered normal limits) within three years of the appearance of microalbuminuria (which constitutes the first clinical indication of diabetic nephropathy). Finally, the incidence of hypertension as a whole is roughly 15-25 percent for patients with microalbuminuria and 75-85 percent for those with clinically evident diabetic nephropathy.

For Type 2 DM, however, the relationship of hypertension and DM is more complex. Hypertension often coexists from the beginning of DM diagnosis, together with the other parameters of the metabolic syndrome (obesity, dyslipidaemia, insulin resistance, increased thrombogenesis, endothelial dysfunction). Thus, roughly 40 percent of Type 2 diabetics have hypertension at the time of DM diagnosis. As a whole, roughly up to 75 percent of patients with Type 2 DM develop hypertension during their lifetime.

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