Diabetes and hypertension: Connection, complications, risks 

Diabetes mellitus (DM) and hypertension (HTN) are closely linked metabolic disorders that frequently coexist, especially in the Indian population. Type 2 diabetics have a three-fold higher risk of developing hypertension compared to non-diabetics, and 50–80% of type 2 diabetes patients have elevated blood pressure. The relationship is bidirectional: diabetes can contribute to hypertension through vascular and renal damage, while hypertension can increase the risk of developing diabetes via mechanisms like inflammation, oxidative stress, and vascular dysfunction.

Both conditions share common risk factors:

• Obesity and overweight status
• Sedentary lifestyle
• Unhealthy diet
• Chronic stress
• Genetic predisposition
• Urbanization and higher socioeconomic status

Prevalence and Trends in India

The prevalence of diabetes in India has risen significantly, with age-standardized rates around 6.1% for women and 6.5% for men, and higher rates in southern states and urban areas.

Hypertension prevalence is even higher, with age-standardized rates of 20% among women and 24.5% among men, and some regions reporting rates above 40%.

The coexistence of diabetes and hypertension is common, and their prevalence is positively correlated with socioeconomic status and urbanization, but remains high even among poorer, rural populations.

Complications and Risks of Coexistence

When diabetes and hypertension occur together, the risks of complications rise dramatically:

Cardiovascular Disease: The risk of cardiovascular disease (CVD) increases by 75% when both conditions coexist, leading to higher morbidity and mortality.

Kidney Disease: Both conditions independently and synergistically increase the risk of chronic kidney disease and renal failure.

Eye Disease: The likelihood of diabetic retinopathy and other eye complications is higher with both diseases.

Stroke and Heart Attack: The risk of stroke, myocardial infarction, and other macrovascular complications is significantly elevated.

Other Complications: Peripheral vascular disease, neuropathy, and sexual dysfunction are also more common.

Conclusion

The coexistence of diabetes and hypertension in India creates a compounded risk for cardiovascular, renal, and other serious health complications. Their rising prevalence-spanning all regions and socioeconomic strata-demands urgent, targeted public health interventions, greater awareness, and integrated management strategies to prevent catastrophic health and economic outcomes.

Prof(Dr)Tirthankar Mukherjee

MD(Internal Medicine), MRCP(UK)
MRCP(Edinburgh), Fellowship in Diabetes (Chennai)
DNB( Internal Medicine), MNAMS
Physician & Diabetologist
Professor & Senior Consultant (KIMS)Bangalore.