Is Hypertension Linked to Neuropathy in Type 1 Diabetes?

Individuals with type 1 diabetes mellitus (T1DM) who have hypertension may be more likely to develop neuropathy, according to a new study.

To determine whether hypertension contributes to impaired nerve conduction, the researchers assessed for diabetic peripheral neuropathy in 70 patients with T1DM and in 78 patients without T1DM. Neuropathic symptoms, signs, and pain were analyzed.

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The researchers also measured the participants’ blood pressure on 2 occassions. Participants were considered hypertensive if 2 sets of measurements yielded an average systolic blood pressure (SBP) of 140 mm Hg or greater—as described in the World Health Organization/International Society for Hypertension guidelines—or if they were taking an antihypertensive treatment.

In all, 40 participants with T1DM had hypertension, and 20 participants without T1DM had hypertension. 

“Hypertension was associated with abnormal nerve conduction parameters, increased vibration perception threshold, and reduced corneal nerve fiber density and length in subjects with T1DM,” according to the researchers. “However, after adjusting for confounding factors, only tibial compound motor action potential and nerve conduction velocity were associated with hypertension and [SBP].”

The researchers found no association between hypertension and neuropathy in participants without T1DM.

“[This study] supports previous small trials showing that angiotensin-converting enzyme inhibitors improve nerve conduction and advocates the need for larger clinical trials with blood pressure lowering agents in [diabetic peripheral neuropathy],” the researchers concluded.

—Colleen Murphy

Reference:

Ponirakis G, Petropoulos IN, Alam U, et al. Hypertension contributes to neuropathy in patients with type 1 diabetes. Am J Hypertens. 2019;32(8):796-803. doi:10.1093/ajh/hpz058.