The diabetic patient as paradigm for selective antihypertensive therapy.
General recommendations from US and international organizations indicate that an ideal approach to the therapy of hypertension should begin with lifestyle modifications, such as decreased salt and fat intake and a careful aerobic exercise program, with the therapeutic goal of a blood pressure (BP) < 140/90 mm Hg. The most recent guidelines recommend more rigorous targets for BP lowering in high-risk populations, such as those with hypertension and concomitant diabetes and/or renal disease with proteinuria. This chapter addresses hypertension in patients with diabetes as an example of a group at especially high risk. It reviews recent clinical trials that support more rigorous BP goals in such patients to reduce cardiovascular morbidity and mortality and considers the importance of combination therapy in achieving these goals.
Sowers
J R
JR
Division of Endocrinology, Metabolism, and Hypertension, Wayne State University School of Medicine, Detroit, Michigan, USA.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008019:Life Style; D008055:Lipids / Q000097:blood; D009765:Obesity; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics; D008055:Lipids