Diabetes: treating hypertension.
BACKGROUND
Among people with diabetes, around 40% of those aged 45 years, and more than 60% of those aged 75 years and over, will have a blood pressure greater than 140/90 mm Hg. Major cardiac events occur in approximately 5% of people with diabetes and untreated hypertension each year, and the risk is higher in those with other risk factors such as diabetic nephropathy.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antihypertensives, and of different blood pressure targets, in people with diabetes? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 22 systematic reviews, RCTs, or observational studies that met our inclusion criteria.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: alpha-blockers, angiotensin II receptor antagonists, angiotensin-converting enzyme inhibitors, beta-blockers, blood pressure targets (lower or higher), calcium channel blockers, and diuretics.
Vijan
Sandeep
S
University of Michigan, Ann Arbor, MI, USA.
D003920:Diabetes Mellitus; D006973:Hypertension; D014481:United States