[Hypertension and diabetes].
Hypertension is often associated with diabetes mellitus. Its physiopathology is different when it's a question of type 1 or type 2 diabetes mellitus. In the case of type 1 diabetes mellitus, hypertension is often the result of a underlying nephropathy. In the case of type 2 diabetes mellitus, hypertension is more often essential and it lies within a plurimetabolic syndrome and insulin resistance context. In all cases, hypertension worsens the patients' prognostics, increasing the risk of macrovascular and microvascular complications. The optimal blood pressure control allows to limit their evolution. It is necessary to fight against all cardiovascular risks like sedentary lifestyle, obesity, tabacco or hyperlipemia. ANAES recommends a blood pressure control lower or equal to 140/80 mmHg. In type 1 diabetes mellitus, the angiotensin converting enzyme inhibitors (ACE) are the first recommended treatment because of their action in case of nephropathy. In type 2 diabetes mellitus, besides ACE, diuretics. beta-blockers can be used in first line. Often, therapeutic associations are necessary.
Bouhanick
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B
Service de médecine B, 4, rue Larrey, 49033 Angers.
Laboureau-Soares Barbosa
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S
Marre
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D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents