Hypertension and diabetes in women

Arterial hypertension and diabetes mellitus are two important and frequent risk factors for atherosclerosis and their association in the same patients is particularly elevated, suggesting something more than the simple causality due to their frequency. In women with diabetes mellitus, the risk of cardiovascular complications is similar to that in men with diabetes mellitus, a pattern completely different from that in the general population where the cardiovascular risk in women is significantly lower than in men. During the gestational period, the glucose metabolism may be reduced and there may be an elevation of blood pressure with or without proteinuria and both conditions have a negative prognostic impact for the mother and for the fetus. On the contrary, reduced glucose tolerance during pregnancy does not seem to represent an important risk factor. The advent of ambulatory blood pressure monitoring has allowed one to evaluate in more detail the pattern of blood pressure in normal pregnancy or pregnancy complicated by diabetes mellitus or hypertension. (C) 2002 Lippincott Williams Wilkins.