Hypertension is extremely common in people with type 2 diabetes, affecting approximately 20-60% of all patients, depending on age, ethnicity, and body weight. The causes of this type of high-blood pressure are unknown, but are likely to be a complex combination of genetic, environmental, and other factors.  A number of genetic factors or interactions between genes play a major role in essential hypertension and many experts believe that specific chromosomes house the genes responsible for blood pressure regulation.

Whereas kidney damage is generally the cause of high blood pressure in type 1 diabetes, obesity and insulin resistance are the factors associated with hypertension in type 2 diabetes.  Obesity is common in both type 2 diabetes and hypertension and clinical testing indicates that obesity is the one common element linking insulin, type 2 diabetes, and high blood pressure. However, studies have found a stronger association between hypertension and insulin resistance in thin patients as well as overweight people with type 2 diabetes.

The development of hypertension in patients with diabetes is particularly harmful, as it is responsible for up to 75% of diabetic cardiovascular complications, including coronary artery disease, peripheral vascular disease, and stroke. Hypertension is also thought to play a significant role in the development of retinopathy (eye damage), nephropathy (kidney disease), and possibly neuropathy (nerve damage).

The gas nitric oxide also plays a predominant role in hypertension.  It can be produced in the body, affecting the smooth muscle cells that line blood vessels by keeping them relaxed and flexible. It may also help prevent blood clotting. Low levels of nitric oxide have been observed in people with high blood pressure (particularly in African Americans) and may be a significant factor in essential hypertension.

Clinical testing and research has explored the benefits of lowering blood pressure in individuals with diabetes, such as a reduction in cardiovascular disease, stroke, or nephropathy events. In older individuals with type 2 diabetes, females in particular, the incidence of heart failure is rapidly increasing, and hypertension is often the primary cause.  Additionally, aside from diabetes, hypertension is the leading cause of end-stage renal disease (ESRD).  Coexisting hypertension and diabetes is a common clinical scenario that can ignite a vicious cycle of rising blood pressure, increasing renal damage, and increased cardiovascular morbidity.  Treatment of hypertension often requires multiple drugs to effectively minimize and prevent complications of diabetes. In patients with type 2 diabetes mellitus, the impact of blood pressure control on micro vascular and macro vascular health may be equal to or even greater than that of strict glycemic control.

Those who have type 2 diabetes must also be aware of secondary hypertension, which has recognizable causes that are usually treatable or reversible.  There are a number of medical conditions that can cause secondary high blood pressure.  The most common of which is kidney disease, although it occurs more often in older diabetics.  Sleep apnea, a disorder in which breathing briefly ceases repeatedly during sleep, is also highly associated with hypertension. A weak but still higher than normal association with high blood pressure has even been observed in those who snore or have mild sleep apnea. The link between sleep apnea and hypertension is thought to be largely due to obesity, but major studies are finding a higher rate of hypertension in people with sleep apnea regardless of their weight. Treating sleep apnea with a device known as nasal continuous positive airway pressure (CPAP) may have modest benefits on blood pressure as well.  Additionally, some medical conditions may contribute to temporary hypertension such as cirrhosis, pregnancy, and Cushing's disease.

To help temporarily aid blood-pressure, people with type 2 diabetes can attain certain prescription and over-the-counter medication.  This includes cough medicines that contain pseudo ephedrine, oral contraceptives, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.  Other causes of secondary hypertension in type 2 diabetics include stress and vigorous exercise, as well as caffeine, cigarettes, and alcohol, all of which could increase the risk of stroke if not limited.

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Malignant Hypertension is caused by a severe rise in blood pressure, which refuses to come down. This condition occurs when the diastolic blood pressure shoots up above 120 mm Hg. Why this characteristic rise or increase in blood pressure takes place is still a mystery.

Malignant hypertension is very common among the people of African origin. It is also found to effect heavy smokers. Those who suffer from high blood pressure are prone to this horrible disease. Youngsters, children and pregnant women, too, are vulnerable to it. Therefore, there is no age group or category of people who are completely immune to it.

Since bringing down malignant hypertension is very difficult, it has a potential to damage some of our vital organs irreparably. The organs that usually get damaged are the heart, brain, eyes, kidneys and blood vessels.

The persons, struggling with malignant hypertension, may exhibit certain definite complaints. Headache and vomiting are frequent symptoms. Cases of confessional periods and less urinary discharge are not rare. Arms, legs and some other areas may experience abnormal sensations, and one may suffer from blurred vision. Malignant hypertension brings restlessness and anxiety. Sluggishness and poor concentration is also experienced by some. Acute weakness is felt and one may suffer from frequent chest pain and breathing problems with or without a cough.

What course would malignant hypertension take is rather unpredictable with the danger of injury to vital organs running high. The consequences could be life threatening, especially in case of the old and infirm.

A very careful approach is required for the treatment of malignant hypertension because if the blood pressure is suddenly lowered it may produce serious adverse effects. This sudden change is as dangerous as high blood pressure kept at a very high level for a long time uncontrolled. With the assistance of a well-qualified doctor, the high-pressure level should be brought down slowly. It doesn’t matter even if it takes several days to decrease the level, but it must be gradual. Carefully prescribed anti-hypertensive medicines should be administered to the patient. Total bed rest provides the much-needed relief and peace to the blood pressure strugglers.

Treated promptly and carefully, this disorder can be controlled to a large extent. When it comes to the malignant hypertension, the demarcation between life and death is actually very thin and feeble. Therefore, every possible care must be taken to get the blood pressure under control.

Primary (aka essential) hypertension has no known cause, however there are a number of lifestyle factors which do seem to effect the chances of developing hypertension.

Risk factors may be related to the environment, genetics and family history, smoking, diet, hormones, how much sodium (salt) you have in your diet or even the level of stress in your life.

Hypertension also increases your risk of having a stroke or heart attack, and can lead to other diseases as well as make other health conditions even worse. It is important to your health and your future to learn about the risk factors and by controlling and altering what you have control over you can change you decrease your risks.

• Exposure to environmental pollutants, such as tobacco smoke, vapors around the office, etc.

• Obesity - being over weight is a factor in hypertension, especially as one ages. Proper diet and weight loss may aid in reversing the associated problems.

• Lack of exercise - Daily 'aerobic' exercise (walking, swimming, running, cycling, etc.) can be very beneficial in decreasing blood pressure, as well as helping with your weight .

• Stress - we could all benefit from a little less of this. Exercise also helps with reducing your stress.

• Lower Alcohol Consumption - Drinking excessively doubles your chances of suffering high blood pressure or a stroke.

• Medicines and prescriptions (Ritalin, hormones, steroids, anti-rejection medications), your doctor and pharmacist should be intimately aware of what you are taking. Illegal drugs can also cause you problems (amphetamines, cocaine, ecstasy).

• Diet - a diet high in sodium puts strain on the blood vessels by increasing the fluid volume in the body (salt attracts water)

These risks can be helped or even controlled with the help of a doctor

• Pregnancy - the extra volume of blood, plus toxemia from high dietary salt intake can put a great strain on the vascular system.

• Kidney failure - the body is unable to remove fluids from the body causing an increase in fluid volume and blood pressure.

• Right-sided Heart Failure - decreases the hearts ability to pump high volumes of fluid through the heart causing a back-up into the blood vessels

Risk Factors over which you have no control

• Family history of hypertension especially onset before the age of 50.

• Age -your increases your chances of getting hypertension

• Gender (male or female)

• Race (Afro-American)

• Nervous System disorders

Secondary Hypertension

While the single cause of Primary hypertension is not known, the cause(s) of Secondary hypertension is and it is usually caused by another condition or disease. Conditions such as arteriosclerosis, diabetes, kidney disease, or even from medications and pregnancy (Gestational hypertension and is one of the reasons your doctor wants to see you more frequently near the end).

Hypertension can be caused either by taking medications or by stopping medications too quickly. Medications such as corticosteroids, birth control pills and other hormones, migraine medications, and medications used for chronic anemia (erythropoieten). Also a number of over-the-counter medications such as cough/cold medications and medications for asthma can cause hypertension.

Medications for hypertension can also cause a rebound hypertension if they are not weaned off of slowly.

Street drugs that can cause hypertension include: alcohol, amphetamines, ecstasy (MDMA and derivatives), and cocaine.

A small number of people experience malignant hypertension. This is an extremely high blood pressure that causes swelling of the optic nerve (the nerve that control vision). This is considered a medical emergency. Many of your vital organs are in serious risk of injury including your brain, your eyes, blood vessels, heart, and kidneys.

One in four Americans has high blood pressure! So who are they?Watch More Health Videos at Health Guru: www.healthguru.com