High blood pressure is called high blood pressure when the pressure of blood against the walls of arteries is higher than normal. The higher your blood pressure, the higher your risk of stroke, heart disease, kidney and liver problems. Hypertension can develop due to environmental, genetic, renal, vascular, or endocrine causes.
Diabetes is a chronic multifactorial disease An absolute or partial deficiency of insulin causes hyperglycemia that affects the nerves and blood vessels of the body. Uncontrolled sugar can adversely affect blood vessels in all organs, especially the heart, brain, kidneys, liver, and eyes.
Diabetes and hypertension are closely linked by similar risk factors such as vascular dysfunction and inflammation, arterial remodeling, atherosclerosis, dyslipidemia, and obesity.
Common mechanisms leading to upregulation of the blood pressure maintenance system, oxidative stress, inflammation, and activation of the immune system contribute to the close relationship between diabetes and hypertension.
how the kidneys are damaged
Persistent uncontrolled high blood pressure narrows, weakens, and hardens the arteries that supply the kidneys. These damaged arteries can no longer carry enough blood to the tissues and damage the kidneys. Damaged kidneys are unable to filter impurities from the blood, causing the kidneys to lose protein and salts.
A similar mechanism is seen in diabetes. High blood sugar can block blood vessels, making them narrower and more prone to leaking.
Diabetes damages the nerves of the bladder, causing a loss of satiety, leading to urinary retention and increased back pressure on the kidneys. These factors slowly and gradually damage the kidneys.
Why the liver is stretched
Hypertension is a potential risk factor for liver injury and liver fibrosis. Hypertension is associated with elevated liver enzymes, especially ALT and GGT. High fat levels in the liver (fatty liver) increase the risk of diabetes, high blood pressure, and kidney disease. The portal vein supplies blood to the liver. Over time, high blood pressure causes collateral vessels to grow. These act as channels to divert blood under high pressure. Excessive pressure on these vessels causes them to dilate and stretch. A diseased liver causes portal hypertension and predisposes to cirrhosis. There is a bidirectional relationship between hypertension and non-alcoholic fatty liver disease (NAFLD). NAFLD causes systemic inflammation, insulin resistance, oxidative stress, vasoconstriction, and gut microbiota-mediated hypertension.
The liver acts as the body’s glucose reservoir. Insulin resistance and hyperinsulinemia are the pathophysiological underpinnings of diabetes in liver disease. Nonalcoholic fatty liver disease, alcoholic cirrhosis, chronic hepatitis C (CHC), and hemochromatosis are more frequently associated with diabetes. Insulin resistance, inflammation and oxidative stress lead to progression from fatty liver to cirrhosis.
