الفهرس | Only 14 pages are availabe for public view |
Abstract To study the role of platelet aggregation in the pathogenesis of hypertension in adult onset diabetes mellitus, 30 adult. onset diabetic patients ( 15 hypertensives and 15 non-hypertensives) were studied in comparison to 10 normal control subjects. Blood sugar measurement, E.e.G, plain X-ray of the chest, fundus.exmination, quantitative estimation of proteins in 24 hours urine; Platelet aggregation, platelet count and plasma renin activity were done for all patients and control subjects. Patients who had abnormal findings by fundus examination were excluded to excluded retinopathy and patients who had proteinuria were excluded to exclude nephropathy thus excluding the possiblity of the present hypertension to be renal in origin. from this study we found simultaneous increase in platelet aggregation and plasma renin activity in both hypertensive and non hypertensive diabetic patients when compared to normal control subjects. Moreover, hypertensive diabetics had a significant increase in platelet aggregation and plasma renin activity when compared to non-hypertensive diabetics. Our findings suggest that increased platlet aggregation may playa role in the pathogenesis of hypertension in diabetics via the formation of small plateletmicrothrombi in the small renal blood vessels thus producing renal iEhemia which stimulates renin -angiotentin system which responds by hypersecretion of renin. from this study we conclude that: platelet aggregation may be increased early in adult onset diabetes mellitus irrespective of the duration of the disease and may be involved in the pathogenesis of hypertension occuring in adult onset diabetic patients. Prospective studies ~n the effect of therapeutic agents such as asprin and dipyridamole on the natural course of diabetic vascular disease are indncated as they may offer a protective tool against diabetic vascular disease. Care should be taken in the use of B-adrenoreceptor blocking agents in treatment of hypertensive diabetic patients as they mask hypoglycemic symptoms. - 95 - The role of diuretics in management of hypertensive diabetic patients is to be re-evaluated as they may further increase renin secretion which may be the inducer of this hypertension. |