Type 2 diabetes mellitus and hypertension: an update

Endocrinol Metab Clin North Am. 2014 Mar;43(1):103-22. doi: 10.1016/j.ecl.2013.09.005. Epub 2013 Dec 12.


Patients with hypertension and type 2 diabetes are at increased risk of cardiovascular and chronic renal disease. Factors involved in the pathogenesis of both hypertension and type 2 diabetes include inappropriate activation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, impaired insulin-mediated vasodilatation, augmented sympathetic nervous system activation, altered innate and adaptive immunity, and abnormal sodium processing by the kidney. The renin-angiotensin-aldosterone system blockade is a key therapeutic strategy in the treatment of hypertension in type 2 diabetes. Emerging therapies for resistant hypertension as often exists in patients with diabetes, include renal denervation and carotid body denervation.

Keywords: Cardiovascular disease; Chronic kidney disease; Diabetes; Hypertension; Renin-angiotensin-aldosterone system; Sympathetic nervous system.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Comorbidity*
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / therapy
  • Humans
  • Hypertension* / epidemiology
  • Hypertension* / metabolism
  • Hypertension* / therapy