In the article, we will consider the most effective drugs for pressure in diabetes.
Hypertension is an increase in blood pressure in which therapeutic manipulations will bring the patient much more benefit than undesirable side effects. With a blood pressure of 140/90 or more, treatment should be started, since hypertension significantly increases the likelihood of blindness, renal failure, stroke and heart attack. In type 1 and type 2 diabetes, the allowable blood pressure limit is reduced to 130/85 mmHg. Art. If the pressure is higher, you need to make all the necessary efforts to lower it.
Hypertension is very dangerous in both types of diabetes. This is due to the fact that the combination of diabetes with high blood pressure increases the likelihood of heart attack, blindness, stroke, kidney failure, amputation of legs and gangrene. At the same time, high blood pressure is not so difficult to normalize, unless the renal pathology has gone too far.
Pressure pills for diabetes are commercially available in large quantities.
Why diabetes causes hypertension
With both types of pathology, the causes of arterial hypertension may vary. Type 1 - in 80% of cases, hypertension develops due to renal damage (diabetic nephropathy). In the second type of diabetes, hypertension most often develops in a patient much earlier compared to impaired carbohydrate metabolism and diabetes itself. One of the elements of the metabolic syndrome (a harbinger of type 2 diabetes) is hypertension or high blood pressure.
Type 1 diabetes - the causes of hypertension are as follows (in frequency): diabetic nephropathy (renal pathology); primary (essential) hypertension; systolic isolated hypertension, other endocrine diseases.
Type 2 diabetes - primary (essential) hypertension; systolic isolated hypertension; diabetic nephropathy, hypertension due to defects in the patency of the renal vessels; another endocrine disease.
Notes. Systolic isolated hypertension is a specific pathology of the elderly. Other endocrine diseases may include Itsenko-Cushing's syndrome, pheochromocytoma, primary hyperaldosteronism, or other rare diseases. Essential hypertension is understood as a condition where the doctor cannot determine for what reason the blood pressure rises. With a combination of hypertension and obesity, the cause most likely becomes intolerance of the patient to dietary carbohydrates, as well as a large amount of insulin in the blood. This is called a "metabolic syndrome", which is well treated. In addition, there may be psychological stress of a chronic nature, a lack of magnesium in the body, intoxication with cadmium, lead or mercury, narrowing of the large artery due to atherosclerosis.
Type 1 diabetes high blood pressure
The main and very dangerous cause of high blood pressure in type 1 diabetes is a violation of the kidneys, which include diabetic nephropathy. This complication occurs in 35-40% of patients with diabetes mellitus and has several stages: microalbuminuria (small molecules of a protein such as albumin appear in urine); proteinuria (kidney filtering is getting worse, large proteins appear in the urine; chronic kidney failure.
Among patients with type 1 diabetes without renal disease, ten percent suffer. In patients with microalbuminuria, this value rises to twenty percent, with proteinuria - up to 50-70%, with chronic kidney failure - up to 70-100%. Blood pressure also depends on the amount of protein excreted in the urine: the more it is, the higher the patient's indices.
With kidney damage, hypertension occurs due to poor kidney excretion of sodium with urine. It becomes more sodium in the blood, the liquid accumulates to dilute it. Excessive amount of circulating blood makes blood pressure higher. If the blood glucose content rises due to diabetes, it draws even more fluid so that the blood does not thicken too much. The volume of circulating blood, thus, increases even more.
Kidney disease and hypertension thus form a vicious cycle that is dangerous for the patient. The body seeks to compensate for the insufficient functioning of the kidneys, and blood pressure therefore rises. It, in turn, increases intracubic pressure. So called filtering elements in the kidneys. The glomeruli as a result gradually die off, the kidneys function worse and worse. This process ends with kidney failure. However, in the early stages of diabetic nephropathy, you can break this vicious circle if the patient is treated in a timely manner. It is important to know which pressure pills for diabetes.
The main thing is to bring the sugar content to normal. Diuretic drugs, angiotensin receptor blockers, and ACE inhibitors also help.
Hypertension in type 2 diabetes
Long before the onset of real diabetes, that is, of the second type, the pathological process originates from insulin resistance, which means reduced tissue sensitivity to the effects of insulin. To compensate for insulin resistance, a very large amount of insulin circulates in the blood, and therefore blood pressure rises. Over time, the lumen of the vessels decreases due to atherosclerosis, which becomes another significant contribution to the appearance of hypertension. At the same time, the patient increases abdominal obesity (near the waist). It was found that adipose tissue released substances into the blood that additionally increased blood pressure. Pressure pills for type 2 diabetes should be selected by a doctor.
This complex is called metabolic syndrome. Thus, hypertension occurs much earlier than the second type of diabetes. It is often detected in a patient immediately after a diagnosis is made. However, a low-carbohydrate diet helps to control both the disease and hypertension. Elevated levels of insulin in the blood are called hyperinsulinism. It arises as a reaction to insulin resistance.
Pressure drugs for type 2 diabetes are quite expensive.
When the pancreas is forced to produce excessive amounts of insulin, it wears out. Over time, she can no longer cope, and there is an increase in blood sugar, the patient develops type 2 diabetes. How does blood pressure rise due to hyperinsulinism? Initially, it activates the sympathetic nervous system; due to kidneys, liquid and sodium are worse excreted with urine; calcium and sodium accumulate in the cells, an excessive amount of insulin thickens the vascular walls, and their elasticity is therefore reduced. Pressure treatment for diabetes should be comprehensive.
The specificity of hypertensive manifestations in diabetes
The natural rhythm of fluctuations in pressure during the day is disturbed in diabetes. In a person, normal blood pressure from 10 to 20% decreases in the morning and night in a dream compared to daily values. Diabetes causes the fact that at night the pressure in many hypertensive patients does not decrease. Moreover, when diabetes and hypertension are combined, pressure at night often rises compared to daytime. It is also assumed that this defect appears due to diabetic neuropathy.
Excessive blood sugar violates the autonomic nervous system, which regulates the vital activity of the human body. Because of this, the ability of blood vessels to regulate their tone deteriorates, that is, relaxation and narrowing depending on the load. Thus, with simultaneous diabetes and hypertension, not only one-time measurements of pressure indicators are needed, but also daily monitoring. It is carried out by means of a special device. The result of this study is the dosage adjustment of tablets that reduce blood pressure in diabetes mellitus and time of administration.
In practice, it is evident that in patients of the first and second type, hypersensitivity to salt is most often observed in comparison with hypertensive patients without diabetes, which means that a strong therapeutic effect can be exerted due to the limited salt in their diet. To treat high blood pressure in diabetes, you need to try eating less salt and evaluate the result in a month. All this is complicated by hypotension of the orthostatic type. This means that the patient’s blood pressure drops sharply when he changes position.
Orthostatic hypotension occurs after a person stands up sharply, in the form of darkening in the eyes, dizziness, or fainting. This problem, like a defect in the circadian rhythm of pressure, appears due to the occurrence of diabetic neuropathy. The human nervous system is gradually losing the ability to control vascular tone. If the patient gets up quickly, then a sudden increase in load occurs. However, the body does not have time to increase blood flow, and health is deteriorating because of this. Orthostatic type hypotension complicates the diagnosis and therapy of high blood pressure. In diabetes, the pressure must be measured in two positions - both lying and standing. If the patient has such a complication, he needs to get up “feeling well” all the time, slowly. In this case, pressure pills for diabetes can also help.
Description of antihypertensive drugs
The drug must meet the following criteria:
- It is good to reduce pressure. In this case, complications occur to a minimum.
- The implementation of the protection of the kidneys and heart from the negative effects of high blood pressure.
- It should not affect lipid and carbohydrate metabolism.
How to choose pills for high blood pressure for diabetes?
Hypertension Medicines
There are several types of drugs that reduce high blood pressure and are successfully used in the treatment of hypertension: calcium blockers, ACE inhibitors, diuretics, beta-blockers, vasodilators, selective alpha-blockers, angiotensin receptor antagonists.
It should be noted that the specialist prescribes an individual treatment course for each patient. Incorrect medication combinations can be fatal. It is strictly forbidden to engage in self-medication.
Use of ACE Inhibitors
The most effective blood pressure pills for diabetes and GB are angiotensin- converting enzyme blockers . The pharmacological effect is aimed at reducing pressure indicators, eliminating the development of heart failure, and reducing tension in the heart muscle tissue.
Admission is contraindicated in the following conditions:
- pulmonary diseases or bronchial asthma;
- when establishing kidney disease in the history of the disease, the drug should be taken with caution, as well as monitoring pressure, monitoring the levels of calcium and creatinine in the blood;
- breastfeeding and pregnancy.
This category of drugs causes the development of arterial narrowing in the kidneys, and therefore it is necessary to prescribe them with caution to those patients who have a history of atherosclerosis.
It is important to know that when using ACE inhibitors, it is advisable to limit salt intake. Dosage during the day - no more than three grams.
The most common blood pressure pills for diabetes are: Berlipril; Enalapril; Captopril. The last pill-medication is an ambulance in urgent cases when the pressure suddenly rises.
Calcium Antagonists for Diabetes Patients
Calcium channel blockers are characterized by long-term effectiveness, can affect hypertension, but there are a number of contraindications. They are divided into the following types: non-dihydropyridines and dihydropyridines.
The most important pathology is a change in calcium metabolism due to magnesium deficiency. The mechanism of action of the drug is aimed at reducing the penetration of calcium and vascular walls into muscle cells of the heart, thus preventing the occurrence of spasms. Blood flows better to important organs.
Contraindications for these drugs are as follows: development of heart failure; the presence of angina pectoris in the medical history; acute stroke; hyperkalemia
The following medicines of this series are prescribed: Diltiazem, Verapamil, Felodipine, Nifedipine. Patients with diabetic nephropathy are prescribed Verapamil, which protects the kidneys from the negative effects of high sugar content. It is necessary to drink in a complex, along with ACE inhibitors.
What other high-pressure pills for diabetes can help?
Essential helpers - diuretics
An increase in the amount of sodium, as well as accumulation of water in the body, causes an increase in the volume of circulating blood, and this becomes an important factor that provokes blood pressure. Patients with high sugar levels are sensitive to salt, which is why the situation worsens significantly. Diuretics become a good tool in the fight against this problem.
The following classification of diuretics is available:
- thiazide - they have such a side effect as a negative effect on cholesterol and sugar, inhibition of renal activity;
- osmotic - can provoke a hyperosmolar coma;
- potassium-sparing - can not be used for kidney failure;
- loopback - with the irresponsible use of such tablets, cardiac arrhythmia and hypokalemia may occur;
- carbonic anhydrase inhibitors - a negative feature is a small targeted effect, due to which the necessary result will not be obtained.
Among all diuretics, given the side effects, it is advised to take loop drugs that lower blood pressure in diabetes. Their action focuses on enhancing the quality of renal activity. Assigned to eliminate edema, perfectly combined with ACE inhibitors. Since the negative point is the elimination of potassium from the body, it is necessary, along with use, to replenish the content of this element through additional drugs.
The best drugs of the loop group are as follows: “Bufenox”, “Torasemide”, “Furosemide”.
Treatment with diuretics alone is ineffective; other antihypertensive drugs are required.
There are other effective pills for high blood pressure for diabetes.
The use of beta blockers
In ischemic and hypertensive heart diseases and arrhythmias, beta-blockers are the indispensable drugs, which distinguish these funds into three groups:
- Non-selective and selective - affect pancreatic cells, reducing the rate of insulin production. Good effect on heart activity, increasing the risk of type 2 diabetes.
- Hydrophilic and lipophilic - can not be used for diabetes, because they stimulate liver pathologies and disrupt lipid metabolism.
- Dilating vessels - have a positive effect on lipid-carbohydrate metabolism, but they have many side effects.
Safe drugs for hypertension are allocated for the second type of diabetes: Corvitol, Bisoprolol, Nebivolol.
The pharmacological effect is aimed at increasing tissue susceptibility to the hormone, as well as the progress of metabolic processes.
It is important to know that beta-blockers hide the manifestations of potassium deficiency, which is why they are prescribed under the supervision of a specialist.
What drugs for pressure in diabetes mellitus are difficult to solve on their own.
Selective Alpha Blockers
The advantage of these drugs lies in the direction of influence on the reduction of lesions of the endings of nerves and their fibers. They differ in combined effects: they are antispasmodic, vasodilating and antihypertensives. In addition, tissue vulnerability to insulin is stimulated, sugar levels are inhibited, and this is necessary for type 2 diabetes.
The disadvantage of these drugs for pressure in diabetes is the possibility of the following conditions:
- swelling;
- orthostatic hypotension - may occur in a patient with diabetes;
- the appearance of persistent tachycardia.
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