[Pathophysiologic basis of arterial hypertension in diabetic patients].
Analysing the already large scope of research dealing with the pathophysiological basis for the increased morbidity due to arterial hypertension in a diabetic subpopulation one may find a mosaics of different mechanisms and proposed hypotheses. Hypertensive diabetics differ in this respect just as te diabetes mellitus and arterial hypertension are differentiated. In this review as the main lines of understanding the hypertensive regulatory abnormalities in IDDM the following possibilities were discussed: 1) genetic predisposition; 2) diabetic nephropathy; 3) influence of hyperglycemia and of the exchangeable Na pool increase; 4) iatrogenic (IDDM) and natural dysinsulinismus (NIDDM), insulin-resistance; 5) hyperreactivity of small vessels related to microangiopathy and autonomic neuropathy to adrenergic impulsation, infusions of catecholamines, angiotensin II, static physical exercise. As probably secondary pathogenetic mechanisms one may consider perturbations in R-A-A functional status, in ANP, PGI2 and PGE2 and kinins secretion and action. The loss of elastic properties by arteries is also an important secondary factor in systolic blood pressure elevation.


CONCLUSIONS
arterial hypertension in diabetic patient needs the individual, pathophysiological differentiation. This may create better therapeutical approach.
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D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*
Patofizjologiczne podstawy nadciśnienia tetniczego u chorych na cukrzyce.