Vnitr Lek 2015, 61(4):335-339

Treatment of hypertension in diabetes mellitus

Jiří Widimský jr
III. interní klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA

Hypertension and diabetes mellitus (DM) are common diseases. Prevalence of hypertension in DM type II is 70-80 %. Goal blood pressure (BP) is around 130/80 mm Hg. RAS blockers (ACE inhibitors or AT1 blockers) are considered as the drugs of choice because of the decrease of cardiovascular risk and prevention of nephropathy. Combination antihypertensive therapy is needed in 80-90 % of pts. Combination of RAS blocker and calcium channel blocker is clinically useful. Diuretics should be part of triple-combination. Low-dose spironolactone can be recommended in severe forms of hypertension. Pharmacological approach should involve also intervention of all other risk factors including BMI reduction in obese subjects. Some of new antidiabetic drugs may lead to significant BP decrease (gliflozines).

Keywords: diabetes mellitus; hypertension; treatment

Received: February 23, 2015; Accepted: March 13, 2015; Published: April 1, 2015  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Widimský J. Treatment of hypertension in diabetes mellitus. Vnitr Lek. 2015;61(4):335-339.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertension 2013; 31(7): 1281-1357. Go to original source... Go to PubMed...
    2. Filipovský J, Widimský J Jr, Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze, verze 2012: Doporučení České společnosti pro hypertenzi. Vnitř Lék 2012; 58(10): 785-801. Go to PubMed...
    3. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998; 317(7160): 703-713. Erratum in BMJ 1999; 318(7175): 29. Go to original source...
    4. Hansson L, Zanchetti A, Carruthers SG et al. Effect of intensive blood pressure lowering and low dose of aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. Lancet 1998; 351(9118): 1755-1762. Go to original source... Go to PubMed...
    5. Staessen JA, Thijs L, Fagard R et al. Effects of immediate versus delayed antihypertensive therapy outcome in the Systolic Hypertension in Europe Trial. J Hypertens 2004; 22(4): 847-857. Go to original source... Go to PubMed...
    6. Patel A. ADVANCE Collaborative Group, Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007; 370(9590): 829-840. Go to original source... Go to PubMed...
    7. Jamerson K, Weber MA, Bakris GL et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008; 359(23): 2417-2428. Go to original source... Go to PubMed...
    8. Cushman WC, Evans GW, Byington RP et al. ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 2010; 362(17): 1575-1585. Go to original source... Go to PubMed...
    9. Lindholm LH, Ibsen H, Dahlhof B et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359(9311): 1004-1010. Go to original source... Go to PubMed...
    10. Remuzzi G, Macia M, Ruggenenti P. Prevention and treatment of diabetic renal disease in type 2 diabetes: the BENEDICT study. J Am Soc Nephrol 2006; 17(4 Suppl 2): S90-S97. Go to original source... Go to PubMed...
    11. Yusuf S, Sleight P, Pogue J et al. Heart Outcomes Prevention Evaluation study investigators. Effects of an angiotensin converting-enzyme inhibitor, ramipril, on cardiovascular events in high risk patients. N Engl J Med 2000; 342(3): 145-153. Go to original source... Go to PubMed...
    12. Lewis EJ, Hunsicker LG, Clarke WR et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345(12): 851-860. Go to original source... Go to PubMed...
    13. Dahlöf B, Sever PS, Poulter NR et al. ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366(9489): 895-906. Go to original source... Go to PubMed...
    14. Agabiti Rosei E, Rizzoni D. Metabolic profile of nebivolol, a beta-adrenoceptor antagonist with unique characteristic. Drugs 2007; 67(8): 1097-1107. Go to original source... Go to PubMed...
    15. Oxlund CS, Henriksen JE, Tarnow L et al. Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus: a double blind randomized clinical trial. J Hypertens 2013; 31(10): 2094-2102. Go to original source... Go to PubMed...
    16. Maliha G, Townsend RR. SGLT2 inhibitors: their potential reduction in blood pressure. J Am Soc Hypert 2015; 9(1): 48-53. Go to original source... Go to PubMed...

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.