Diabetes and hypertension. What is new?
Diabetes mellitus and hypertension are interrelated diseases that strongly predispose to atherosclerotic cardiovascular disease. If blood pressure control is critical to improve cardiovascular prognosis in the hypertensive population, this is even more important in high risk patients, such as those with diabetes. Despite that, most of them do not achieve blood pressure targets. The inhibition of the renin angiotensin system is the first logical therapy in the management of hypertensive patients with diabetes. However, since most of them will need at least two antihypertensive agents to attain blood pressure goals, the current question to be answered is which drugs are the best to associate. According to available evidence, two are the main options: a diuretic or a calcium channel blocker. Many beneficial effects have been described with the use of both. The recent results of ACCOMPLISH trial started to clarify this issue. However, there are still many questions to be resolved before a categorical recommendation may be given about this matter. In the present manuscript, the current data about the treatment of patients with hypertension and diabetes are reviewed.
Barrios
V
V
Department of Cardiology, Hospital Ramon y Cajal, Madrid, Spain. vbarriosa@meditex.es
Escobar
C
C
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000517:prevention & control; D003930:Diabetic Retinopathy / Q000517:prevention & control; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System; D012306:Risk; D012307:Risk Factors
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D006442:Glycated Hemoglobin