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DIABETES & HYPERTENSION
Transcript of DIABETES & HYPERTENSION
PARTNERS IN CRIME
The Two Terrorists
Dr. Tariq Waseem
Professor of Medicine
King Edward Medical University, Mayo Hospital, Lahore
Pakistan is 7th largest country in terms of Diabetes population and it will be 4th largest by the year 2030.
WHO 2011: 12.9 million people with diabetes (8% of total population) Diagnosed : 9.4 million, Undiagnosed: 3.5 million Pre diabetes: 38 million people 20.5% women and 15.9% men have prediabetes .
NHSP: Hypertension affects 18 percent of adults over 15 years of age and 33 percent of adults above 45. Only 50 percent of those affected are diagnosed. out of the 50 percent people diagnosed only half are treated.
What Causes HTN in DM
Metabolic Syndrome- Mainly IR, BG, Obesity, ED
Excessive RAAS Acivity
HTN d/t Nephropathy in T2DM-GS-KWS
Renal Scarring : Recurrent Pyelonephritis
Endocrine : Cushing's, Conn's, Pheochromocytoma, Acromegaly
Coincidental: DM on existing Hypertension
Diabetogenic Antihypertensive drugs (D&B)
Drugs causing both HTN Dm : OCP, CS
Difficulties of HTN in DM
Relative Risk of DM + HTN
Systolic HTN more common in DM
S-HTN is a stronger predictor of CVE
65% of T2DM have S-HTN
S-HTN is more difficult to control
Depression is more in DM – Adherence Rx
‘Clinician Inertia’ is a big problem
Glycemic control is the Only focus.
Evidence: Morbity & Mortality DM + HTN
NEW GUIDELINES In Management Of Hypertension
Diabetes + HTN versus Diabetes
• Neuropathy 1.6
• Nephropathy 2.0
• Retinopathy 2.0
• Stroke 4.0
• CHD 3.0
• Mortality 2.0
DM + HTN COMPLICATIONS
CLINICAL TRIALS EVIDENCE