Common complications of hypertension: risks and prevention of diabetes, kidney disease, etc.

Hypertension and Diabetes: Recent studies show that patients with primary hypertension often also have metabolic disorders related to glucose and lipids. Some jokingly refer to hypertension, diabetes, and hyperlipidemia as "sister diseases," which is not an exaggeration. Patients often present with hypertension, insulin resistance, hyperinsulinemia, impaired glucose tolerance, elevated very low-density lipoprotein (VLDL) or triglycerides, and decreased high-density lipoprotein (HDL) cholesterol. Experts believe that insulin resistance may be the common pathophysiological basis of obesity, non-insulin-dependent diabetes mellitus, hypertension, and atherosclerosis. Hypertension and diabetes are often mutually causal and closely related. The peak incidence of hypertension in diabetic patients is 10 years earlier than in normal individuals. Furthermore, the incidence of hypertension increases significantly with age and weight, and patients also experience more complications.

Insulin resistance refers to a decrease in the sensitivity and responsiveness of organs and tissues acting on insulin, such as the liver, muscles, and adipose tissue, leading to a series of pathological changes and clinical diseases. Insulin resistance is a common underlying cause of many diseases, such as non-insulin-dependent diabetes mellitus, obesity, hypertension, hyperlipidemia, and coronary heart disease. Insulin resistance is related to genetics and has a family history. Individuals with a direct family history of hypertension, coronary heart disease, diabetes, obesity, hyperlipidemia, stroke, or myocardial infarction should pay close attention.

After insulin resistance develops, compensatory increases in insulin secretion occur, leading to hyperinsulinemia. When the pancreatic islet cells are chronically overworked and unable to cope with this compensation, blood sugar levels rise excessively, resulting in diabetes. Insulin resistance and hyperinsulinemia often exist in the early stages of diabetes, and also in the period several to over a decade before the onset of diabetes. During this time, although blood sugar may remain normal, it still contributes to hypertension, hyperlipidemia, and atherosclerosis, subtly harming health.

Hypertension Complicated with Pregnancy: For pregnant women with hypertension, whether the hypertension is caused by pregnancy or pre-existing hypertension, attention should be paid to their cardiac and renal function to prevent eclampsia and hypertensive crisis. Regular follow-up is essential to monitor for placental abruption. While antihypertensive medication is necessary, it should be used cautiously, and blood pressure should not be lowered excessively to avoid affecting fetal blood supply.

Hypertension Complicated with Kidney Disease: Hypertension complicated by kidney failure accounts for approximately 10% of cases. Hypertension and the kidneys have a close and complex relationship. On the one hand, hypertension causes kidney damage; on the other hand, kidney damage exacerbates hypertension. Hypertension and kidney damage can influence each other, creating a vicious cycle. Rapidly developing hypertension can cause widespread diffuse renal arteriolar lesions, leading to malignant renal arteriolar sclerosis and rapidly progressing to uremia.

Hypertension Complicated with Peripheral Artery Disease: Hypertension increases the risk of intermittent claudication by three times, possibly because elevated blood pressure accelerates sclerosis in specific areas such as the lower limb arteries, carotid arteries, and coronary arteries, leading to ischemia, nutritional deficiencies, and even necrosis of the lower limb arteries.