老年糖尿病伴高血压患者血压昼夜节律变化的探讨

目的：观察老年糖尿病伴高血压患者血压昼夜节律变化。方法：运用24h动态血压监测，并比较68例糖尿病伴高血压患者和42例原发性高血压不伴糖尿病的患者的血压资料。结果：糖尿病伴高血压组夜间收缩压明显高于对照组（P〈0．01）；其血压昼夜差值、节律变化与对照组的差异有显著性（P〈0．05）。结论：昼夜血压差值减小或消失是反映糖尿病伴高血压患者血压调节功能受损的一项指标。     

动态血压监测在糖尿病高血压患者的应用

糖尿病合并高血压的发病率很高，可是高血压控制现状不理想，其中一个重要原因是血压评估方法尚有一定误区。动态血压监测应该成为评估糖尿病高血压患者血压控制与指导抗高血压药物治疗的主要方法。     

2型糖尿病继发高血压的早期诊断与治疗

2型糖尿病（T2DM）是常见的代谢性疾病,而高血压是T2DM患者常见的并发症之一。随着生活方式的改变和人口老龄化的加速,我国T2DM患者继发高血压的患病率逐年上升。二者并存时对心血管系统有极强的危害,是严重影响人们健康的慢性非传染性疾病。对T2DM人群进行早期诊断和治疗,对预防T2DM血管并发症、预防心血管事件的发生、提高生存质量、延长患者寿命具有十分重要的意义。     

糖尿病合并高血压患者动态血压控制状况调查

目的了解糖尿病合并高血压患者动态血压控制状况，为降压治疗提供依据。方法2004年1～11月在我所就诊的正在进行降压药治疗的糖尿病合并高血压患者的49例进行了动态血压监测。结果糖尿病合并高血压患者24h平均收缩压、24h平均舒张压、日间平均血压、夜间平均舒张压控制率均〉50％，但是夜间平均收缩压、夜间血压下降比例控制率较低。结论糖尿病合并高血压患者还需要加强对夜间血压的控制，临床需重视动态血压监测对降压治疗的指导作用。     

Ⅱ型糖尿病合并高血压者24h动态血压监测

原发性高血压病(EH)与Ⅱ型糖尿病关系十分密切,二者均为心脑血管疾病的主要危险因素。现对30例Ⅱ型糖尿病合并EH者24h动态血压(ABPM)并与30例单纯EH作对照,旨在探讨血压的昼夜节律变化及血压总体水平,现将结果报告如下。     

抗高血压药物与新发糖尿病

复习近年有关研究及相关文献,旨在了解新型抗高血压药物与传统的抗高血压药物对新发糖尿病的影响。     

糖尿病伴高血压的治疗

高血压在糖尿病中非常常见 ,不同种族、不同年龄不同 ,总体状况糖尿病伴高血压的患病率约在 2 0 %～ 6 0 %之间。 1型糖尿病发生高血压多数继发于糖尿病肾病。 2型糖尿病中 ,高血压常做为代谢综合症的一部分并存。我国成人糖尿病中高血压的患病率约在 30 %～ 5 0 %。1　我国成人糖尿病高血压的患病率[1]1994年 ,全国 19省市 2 5万人群 2 5岁以上成人糖尿病普查的资料库中 ,按 1999年ＷＨＯ糖尿病诊断标准判定的糖耐量正常 (ＮＧＴ)、糖耐量低减 (ＩＧＴ)和糖尿病 (ＤＭ)共 15 6 6 0人。总体人群中 ,血压≥ 130 / 80ｍｍＨｇ者 6 449人 ,占 4…     

高血压合并糖尿病的治疗进展

高血压和糖尿病均可引起心、脑、肾和眼底等靶器官损害,但两者合并存在时,对靶器官的损害决非简单相加。对于血压水平相同的高血压患者,有、无糖尿病其心血管事件发生率可相差10～20倍。近年来,对于控制血压对糖尿病治疗的重要意义有了更充分的认识。事实上,控制血压比控制血糖对减少糖尿病并发症的发生和死亡有着更重要的作用。本文就高血压合并糖尿病的临床治疗研究进展综述如下:     

高血压与糖尿病

高血压与糖尿病关系密切。近年来国外学者对两种疾病的关系进行了诸多方面的研究,试图从体液和细胞学水平揭示高血压和糖尿病相互影响的机制。本文就这方面的进展做一综述。     

高血压合并糖尿病患者血压变异性的研究进展

血压变异性是指一定时间内血压的波动程度,其反映自主神经对血管调节的动态平衡。高血压合并糖尿病患者的自主神经功能紊乱、血管内皮损伤、炎症反应等都会引起血压变异性增大,从而增加心脑血管事件的发生率和病死率。稳定血压变异性,成为临床上预防、诊断和治疗高血压合并糖尿病的可行措施。     

Diabetes and Hypertension

The incidence of hypertension is increased in individuals with diabetes mellitus. This is especially true in patients with type 2 diabetes. In these patients high blood pressure is common at the time of diagnosis of diabetes, but the development of diabetes is often preceded by a period during which hyperinsulinemia and insulin resistance is already present. Diabetes represents by itself a major risk of cardiovascular morbidity and mortality. This risk is considerably enhanced by the co-existence of hypertension. One of the main complications of type 2 diabetes is nephropathy, which manifests initially by microalbuminuria, then by clinical proteinuria, leading to a progressive chronic renal failure and end-stage renal disease. Microalbuminuria is considered today as an indicator of renal endothelial dysfunction as well as an independent predictor of the cardiovascular risk. During recent years a number of studies have shown that tight blood pressure control is essential in diabetic patients in order to provide maximal protection against cardiovascular events and the deterioration of renal function. Of note, there is recent evidence indicating that blockade of the renin-angiotensin system with angiotensin II antagonists has marked nephroprotective effects in patients with hypertension and type 2 diabetes, both at early and late stages of renal disease.     

Hypertension and Diabetes

Co-presentation of hypertension and diabetes leads to a significantly greater increase of cardiovascular mortality than each disease separately. Hypertension appears to be not only a complication of diabetes but apparently also shares a common pathogenetic mechanism, particularly in non-insulin dependent diabetes. Recent data suggest alterations in the nocturnal decline of blood pressure in diabetics, which together with microalbuminuria, may prove to be a predictor of nephropathy and hypertension. When hypertension occurs in diabetics, it requires a vigorous therapeutic approach. Nevertheless, the presence of diabetes modifies the requirement for first line therapy, particularly with respect to potential alterations of metabolic homeostasis in order to effectively prevent cardiovascular complications.     

高血压、糖尿病与肥胖

近年来,高血压、糖尿病及其相关疾病的患病率日益增高,伴随肥胖者逐渐增加,因此,研究高血压、糖尿病与肥胖的相关性已成为21世纪心血管和内分泌领域的热点,现将此方面的研究进展作一综述.     

糖尿病并高血压、高胰岛素血症

对１１２例Ⅱ型糖尿病（并高血压及无高血压各５６例和２０例高血压患者测定空腹胰岛索水平，发现高血压、糖尿病并高血压的胰岛素与血清甘油三酯水平均明显高于正常值，也高于糖尿病无高血压组（Ｐ＜０．００１）。糖尿病并高血压的并发症以冠心病为多。     

Pathogenesis of Hypertension in Diabetes

Reviews in Endocrine and Metabolic Disorders -     

Diabetes and Hypertension: Prognostic and Therapeutic Considerations

Hypertension and diabetes are common disorders which frequently co-exist. Both are risk factors for atherosclerotic vascular disease and their combination is associated with an increased incidence of nephropathy, ischaemic heart disease, peripheral vascular disease, and stroke. Several trials such as the HDFP and SHEP studies that included diabetic patients have demonstrated the beneficial effects of antihypertensive therapy in reducing mortality. In diabetes, studies have focussed predominantly on the efficacy of antihypertensive therapy in reducing the progression of diabetic kidney disease. Such therapy has been shown to decrease albuminuria in the setting of “normal” and elevated blood pressure in both type I and type II diabetic patients. This reduction in albuminuria has been observed in microalbuminuric diabetic patients and also in those with overt renal disease. Recent studies in type I diabetic patients with overt nephropathy indicate that these effects on urinary albumin excretion are associated with reduction in the rate of decline in renal function and development of end-stage renal failure. Indeed, several groups have shown that the initiation of antihypertensive therapy improves the prognosis of type I diabetic patients with nephropathy. While certain classes of drugs may reduce the rate of progression of complications such as nephropathy, others have side effect profiles that are disadvantageous in patients with diabetes.     

高血压糖尿病患者的护理干预效果探讨

目的探讨护理干预在高血压糖尿病患者中的应用效果。方法选取2014年4月—2015年3月期间该院收治的高血压糖尿病103例患者进行该研究,根据不同的护理方式将其分为常规组和综合组,常规组50例患者采取常规的护理干预措施,综合组53例患者采取综合性护理干预措施,比较两组患者的护理效果。结果常规组的护理满意度低于综合组的护理满意度,差异有统计学意义(P0.05),护理前,两组患者的生活质量和疾病知识知晓情况差异无统计学意义(P0.05),护理后,综合组患者的生活质量和疾病知识知晓率的评分均高于常规组(P0.05)。结论综合性护理干预应用于高血压糖尿病患者能显著改善患者的生活质量,提高患者相关疾病的知晓率和护理满意度,具有推广应用价值。     

糖尿病并高血压患者并发症的临床分析

对糖尿病并高血压６９例和糖尿病血压正常者９４例比较分析，并高血压者易加重心脑血管病、肾病变、视网膜病变及感染（Ｐ＜０．０１），下肢血管病及神经病变两组相近似。