Controlling hypertension in diabetes.
Patients with type 2 diabetes are especially vulnerable to both large and small vessel injury from elevated arterial blood pressure. The frequent combination of hypertension and diabetes is, therefore, associated with a high risk of cardiovascular events and end-stage renal disease. The beneficial therapeutic effects of angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers (CCBs), and other antihypertensive drugs in patients with type 2 diabetes have been well established in placebo-controlled trials, and there appears to be no evidence of differences between treatment regimens based on different drug classes. In addition, a number of major clinical trials have supported a policy of aggressive blood pressure lowering in patients with type 2 diabetes. In the UK Prospective Diabetes Study, for example, tight control of blood pressure was demonstrated to produce clinically important reductions in the risk of complications related to type 2 diabetes compared with less tight control. In most hypertensive patients, however, a reduction to a recommended level <130/85 mm Hg is unlikely to be achieved by monotherapy. Consequently, the combination of ACE inhibitors with other first-line drugs, such as CCBs, diuretics and beta-blockers, is recommended for the therapeutic management of hypertensive diabetic patients.
Parving
H H
HH
Steno Diabetes Center, Gentofte, Denmark.
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002986:Clinical Trials as Topic; D015897:Comorbidity; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*
D000959:Antihypertensive Agents