<![CDATA[Introduction: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease frequently complicated by diabetic peripheral neuropathy (DPN), which substantially impairs the quality of life and predisposes patients to foot ulceration and amputation. Hypertension, a highly prevalent comorbidity in T2DM, is an important modifiable risk factor for DPN. This review aims to synthesize the current evidence on the association between hypertension and DPN in patients with T2DM and elucidate the underlying pathophysiological mechanisms. Methods: A narrative literature review was conducted using electronic databases, including PubMed and Google Scholar, to identify clinical, epidemiological, and experimental studies that examined the relationship between blood pressure and DPN in patients with diabetes. Results: Observational studies across diverse populations consistently demonstrated that coexisting hypertension is associated with a higher prevalence and greater severity of DPN, and multivariate analyses identified hypertension as an independent risk factor after adjusting for age, diabetes duration, and glycemic control. Mechanistically, hypertension acts synergistically with chronic hyperglycemia to aggravate endothelial dysfunction, oxidative stress, inflammation, and structural remodeling of the vasa nervorum, resulting in endoneurial hypoxia, demyelination, and accelerated nerve degeneration. Experimental and imaging studies have corroborated more severe nerve injury when both conditions coexist. Conclusion: Hypertension is a modifiable contributor to the development and progression of DPN in patients with T2DM. Blood pressure control, alongside glycemic management, should be integrated into DPN prevention strategies, and interventional studies are warranted.]]>
