Why type 2 diabetes and high blood pressure so often appear together

Researchers have identified several genetic pathways that may help explain why type 2 diabetes and high blood pressure frequently occur in the same person. The findings also indicate that people with the same two conditions may arrive there through different biological routes.

That distinction could one day sharpen early risk prediction and guide more personalized prevention strategies. It also reinforces the idea that treating the two illnesses as completely separate problems can overlook part of their shared basis.

A team from the University of Surrey, the University of Lille and partner institutions examined 1,304 genetic variants associated with type 2 diabetes and blood pressure. Published in Nature Communications, the study organized these variants by the health patterns and biological processes linked to them.

Genes contain instructions that shape how the body functions. A genetic variant is a small change in those instructions, and many common variants each contribute only a modest amount to disease risk.

The researchers identified five broad clusters. These were connected to problems with how the body uses energy, insulin-producing cells in the pancreas, higher body fat, blood vessel function and a contrasting pattern in which diabetes risk and blood pressure do not rise together.

The pancreas produces insulin, the hormone that helps regulate blood sugar. When insulin-producing cells do not function properly, the path to diabetes may differ from one involving excess body fat or blood vessel-related issues.

That diversity was central to the study’s conclusion. Rather than finding a single universal gene driving both conditions, the researchers uncovered a set of partly shared processes that can combine differently from person to person.

Using these clusters, the team built separate genetic risk scores and tested how well they identified people likely to have both diabetes and high blood pressure, the medical term for high blood pressure.

Validation using data from more than 450,000 people in UK Biobank showed that certain genetic profiles identified people with more than twice the usual susceptibility to the combination, suggesting that separating the pathways could improve prediction.

Even so, a higher genetic score does not mean a person will definitely develop either condition. Age, lifestyle, diet, activity and other factors still matter, and a research score is not yet ready for routine clinical use.

The study also did not examine whether treatment choices based on genetic clusters improve outcomes. That would require further research, including testing in different populations and comparing the approach with current risk-assessment methods.

The findings help make the overlap between diabetes and blood pressure easier to understand. Two people may share the same diagnoses while carrying different underlying vulnerabilities, and recognizing those differences may eventually support more individualized care.

Source: University of Surrey and University of Lille.