Hypertension and diabetes are both predicted by insulin resistance

Insulin resistance, diminished insulin receptor sensitivity requiring higher levels of insulin to maintain normal blood glucose, is the precursor of diabetes. Factors contributing to insulin resistance and higher levels of insulin both have adverse circulatory effects. A study published in the journal Hypertension demonstrates the strong connection by showing that elevation in blood pressure predicts type 2 diabetes and vice versa. The authors state:

"Type 2 diabetes mellitus and hypertension overlap in the population. In many subjects, development of diabetes mellitus is characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs during the development of hypertension is not known."

Hypertension and diabetes closely track each other

They analyzed blood pressure (BP) changes in subjects with and without diabetes using data from two population-based studies over a 7-year period and found a close connection.

"Diabetes mellitus at baseline was a significant predictor of incident hypertension (in FOS, odds ratio, 3.14) independently of sex, age, body mass index, and familial diabetes mellitus. Conversely, hypertension at baseline was an independent predictor of incident diabetes mellitus (odds ratio, 3.33. In >60% of the converters, progression from normotension to hypertension was characterized by a steep increase in BP values, averaging 20 mm Hg for systolic BP within 3.5 years (in MCDS)."

Insulin resistance is the common denominator

High blood pressure and blood glucose both have insulin resistance as a driving factor. Bear in mind that elevated BMI, waist circumference and triglycerides also result from higher levels of insulin that force storage of calories as visceral fat.

"In comparison with the nonconverters group, hypertension and diabetes mellitus converters shared a metabolic syndrome phenotype (hyperinsulinemia, higher body mass index, waist girth, BP, heart rate and pulse pressure, and dyslipidemia). Overall, results were similar in the 2 ethnic groups."

The authors conclude...

"...that (1) development of hypertension and diabetes mellitus track each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BP values, and (3) insulin resistance is one common feature of both prediabetes and prehypertension and an antecedent of progression to 2 respective disease states."

Readers may be interested in the extensive monograph Insulin resistance increases cardiovascular disease.