A Comparison and Contrast of Hypertension and Diabetes

By Shaimaa Fawzi

     Hypertension and diabetes are two potentially deadly diseases. Hypertension is a condition in which blood pressure is persistently elevated to higher than 140 over 90 in adults. The first number represents the pressure when the heart contracts. This pressure is called systolic blood pressure, and it is normally around 120. The second number represents the pressure when the heart relaxes, which is called diastolic pressure, and it is normally around 80 (What is high blood pressure?, “n.d.”). On the other hand, diabetes is a disorder that results from an elevation in the level of blood glucose or when the body can not produce insulin (Drury, Howell, & Watkins, 1996).

     In the United States, 17 million people suffer from diabetes (What is high blood pressure?, “n.d.”). One third of them unfortunately do not know that they have it while hypertension affects more than 50 million Americans (Basic diabetes information, “n.d.”). Like diabetes, millions of people with hypertension do not know that they have it. This paper will discuss four aspects – causes, symptoms, complication, and treatment –  in which hypertension and diabetes correspond and differ.

     First, hypertension and diabetes can be compared and contrasted according to their causes. There are two types of hypertension: primary hypertension and secondary hypertension. Primary hypertension is high blood pressure for which no cause can be found, but secondary hypertension has definite causes (Segen, 1992). The heart pumps blood through the body’s arteries to all parts of the body. When the blood vessels become narrow, the flow of blood through them will be harder, so the blood will exert the wall vessels and increase the pressure in them. Similarly, diabetes has two types. Type 1 diabetes is one type that occurs because of the failure of making the hormone called insulin by the pancreas. The other type is type 2 diabetes that is due to failure of using insulin by the body; in other words, diabetes occurs when the body can not produce or use insulin.

     The body uses insulin to convert sugar, starch, and other food into energy that can be used by the body in movement or other functions in daily life. This hormone is produced by cells called beta cells. These cells exist in the pancreas. When these cells are damaged, the body can not produce insulin. The most common cause of damaging beta cells is that cells of immune system attack the beta cells instead of germs. This deficiency of insulin leads to an increase in the level of blood glucose, so diabetes occurs.

     Furthermore, there are environmental and genetic factors that play a role in causing hypertension and diabetes. First, environmental factors are obesity, smoking, and lack of exercise. These factors affect the body and its function and lead to elevation of the blood pressure and affect the production of hormones. When a person becomes obese, s/he will have more fat tissue in the body. The heart pumps blood through the body to supply each part with oxygen and nutrition. In an obese person, the blood contains excessive fats. That makes the blood thicker, heart muscles will not able to withstand this overload and pump less powerfully, and this thick blood will exert more pressure on the walls of vessels. This will lead to hypertension. An obese person consumes fat and carbohydrates in excess; as a result, the insulin produced will be insufficient for its conversion, then, the level of blood glucose will increase, and diabetes will occur. Smoking is another environmental factor of hypertension and diabetes. The nicotine in tobacco causes narrowing in the blood vessels and leads to high blood pressure. In diabetes, nicotine increases the level of insulin in the blood and increases insulin resistance.  The sex and the family history of patients are the genetic factors for people who have others in their family with diabetes or hypertension.

     Also, there are differences and similarities between the two diseases according to their symptoms. Hypertensive and diabetic patients share some symptoms. These symptoms are fatigue and vision changes; however, they differ in many symptoms. The symptoms of hypertension are headache, confusion, vomiting, and chest pain. However, hypertension often has no symptoms, which is why it is called the silent killer; in contrast, the symptoms of diabetes are frequent urination, excessive thirst and hunger, unusual weight loss, and irritability.

     The third aspect for comparison and contrast is complications. Both hypertension and diabetes lead to heart attack, stroke, kidney damage, and blindness. When the blood pressure becomes high, the heart will pump more often than normal. It causes in overload on the heart muscles, which are not able to stand this overload. Furthermore, the muscles may weaken so that their efficiency decreases; then, the heart is affected, and heart failure happens. Hypertension is a major risk factor for cardiovascular disease (Krum et al., 2002).  In addition to heart attack, hypertension leads to stroke. Hypertension produces stress on blood vessel walls in part of the brain. This stress leads to blockage of the blood vessels and makes a clot in the brain. This clot will prevent blood from reaching a part of the brain tissue. When the tissue is cut off from its supply of oxygen for more than three to four minutes, it begins to die; in addition, high blood pressure can damage the small blood vessels in the kidneys. The damaged vessels can not filter poisons from the blood as they are supposed to. Also, diabetes leads to heart attack. It begins with damage in the inner layer of the artery; then, the artery wall cells will build up plaque and may produce other substances that result in further build up of plaque. This leads to a clot in the arteries and stops the blood flow. If this clot occurs in the heart arteries, it leads to a heart attack, but if it occurs in the brain arteries, it leads to a stroke.  

     Hypertension and diabetes have dangerous effects in pregnant women. When a pregnant woman has hypertension, the blood and oxygen supply will diminish to mother and baby. This deficiency will develop into pre-eclampsia. Pre-eclampsia is a condition that affects pregnant women and causes swelling and increases protein in the urine. The symptoms of pre-eclampsia are headache, spots before the eyes, heartburn, and swelling in the face and hands. It can decrease the baby’s movement; also, the baby may have problems with growing and getting enough oxygen, and the baby may develop other complications. In contrast, when diabetes occurs during pregnancy, it is called gestational diabetes. This type of diabetes develops during pregnancy due to hormonal changes between weeks 24 and 28 and disappears when a woman gives birth. Gestational diabetes can cause complications that affect both mother and baby. When the mother’s body cannot convert glucose to energy, the blood glucose will increase and cross the placenta. The baby’s body will produce insulin to decrease the blood glucose level in the baby’s body; then, insulin will convert extra glucose to energy. This energy will be more than the baby’s needs. The body will store this excess energy as fat; after that, fat baby or macrosomia will occur. The baby will develop health problems such as damage to her/his shoulders during birth, low blood glucose and higher risk for breathing problems. These babies have risk factors for obesity and type 2 diabetes. Gestational diabetes develops in about 3 percent of all pregnant women, and up to 50 percent of women with gestational diabetes will develop permanent type 2 diabetes within 10 to 15 years (Basic diabetes information, “n.d.”). 

     However, hypertensive and diabetic patients differ in other some complications. Diabetic patients can develop many different feet problems. Diabetes can lead to nerve damage or reduction in the blood flow in feet, so the feet problems will occur. In addition, diabetes leads to skin disorder. This skin disorder affects one-third of people with diabetes, and it can be considered as the first sign that a person has diabetes (Basic diabetes information, “n.d.”). Furthermore, diabetic neuropathy is another complication of diabetes. Neuropathy is damage in peripheral nerves that connect the spinal cord to muscles, skin, blood vessels, and other organs (Basic diabetes information, “n.d.”). On the other hand, brain damage and blood vessel damage result from hypertension because when the blood pressure is high all the time, it will lead to an increase in the force on the blood vessel walls and damage to the blood vessels.

     In addition to complications, diabetes and hypertension can be compared and contrasted according to treatment. The treatment of both hypertension and diabetes includes two types: changing lifestyle and medication. Hypertensive patients must change their lifestyle. They must eat food with low salt and fat; also, they must stop smoking and consuming alcohol. They must exercise to save their health; furthermore, the patient must take medication to reduce high blood pressure or to avoid narrowing in the blood vessels (Segen, 1992). In contrast, diabetes can be treated by a well balanced diet that contains all basic essentials. They must also exercise and lose weight to control the level of glucose in the blood. Diabetic patients need medication that helps to boost their natural insulin or help the body use insulin. Some adults with diabetes need insulin shots (Thomas, 1997).

     In conclusion, this paper compares and contrasts hypertension and diabetes by their causes, symptoms, complications, and treatment. When the blood vessels become narrow, hypertension occurs while the deficiency of insulin results in diabetes. Fatigue and vision changes are common symptoms between these two diseases; however, there are many differences in symptoms between them. In addition, hypertension is very much like diabetes in that they both lead to similar complications such as heart attack and stroke. Finally, both hypertension and diabetes can be treated by two methods: changing lifestyle and taking medications. Changing lifestyle includes a certain diet and weight loss. Each disease needs certain medications. The patients with hypertension or diabetes must control their disease to avoid their dangerous complications and death.

1.      Systolic blood pressure is elevated higher than ___ in hypertensive adults?

a.       +80

b.      +90

c.       +120

d.      +140

2.      A cause can be found for ___ hypertension.

a.       primary

b.      secondary

c.       type 1

d.      type 2

3.      Insulin is produced by ___.

a.       the pancreas

b.      beta cells

c.       glucose

d.      the heart

4.      ___ for both hypertension and diabetes.

a.       Smoking is a contributing factor

b.      Obesity is a contributing factor

c.       Genetics is a contributing factor

d.      all of the above

5.      Hypertension’s and diabetes’ effects differ in ___ ways.

a.       1

b.      2

c.       3

d.      4

6.      Diabetic neuropathy affects ___.

a.       the skin

b.      the nerves

c.       the brain

d.      the spine

7.      A baby is at risk of developing ___ if the mother has diabetes.

a.       macrosomia

b.      hypertension

c.       diabetic neuropathy

d.      all of the above

8.      A pregnant mother is at risk of developing ___.

a.       gestational diabetes

b.      pre-eclampsia

c.       both a and b

d.      neither a nor b