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Calcium antagonists in patients with type 2 diabetes and hypertension
Samy I McFarlane1, Amal Farag, James Sowers
1Division of Endocrinology, Diabetes and Hypertension, Department of Medicine and Biochemistry, State University of New York, Health Science Center at Brooklyn, 450 Clarkson Avenue, Box 50, Brooklyn, NY 11203, USA. immgss@aol.com.
Insights
Hypertension is common in diabetes, increasing cardiovascular risk. Calcium channel blockers are effective for blood pressure control in diabetic patients, especially in combination therapy.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Hypertension is twice as prevalent in diabetic patients, contributing significantly to cardiovascular disease (CVD) risk, morbidity, and mortality.
- Effective blood pressure control in diabetes reduces CVD risk and improves outcomes, particularly stroke prevention.
- Current recommended blood pressure goal (<130/80 mm Hg) is achieved by less than one-third of diabetic patients due to complex hypertension characteristics.
Purpose of the Study:
- To review the role of calcium channel antagonists in managing hypertension in patients with diabetes.
- To highlight the challenges in blood pressure control for diabetic patients and the need for combination therapy.
Main Methods:
- Review of randomized controlled trials and clinical data on hypertension management in diabetic populations.
- Analysis of the efficacy and safety of calcium channel antagonists in this specific patient group.
Main Results:
- Calcium channel antagonists demonstrate safety and efficacy in controlling blood pressure in diabetic patients.
- Diabetic hypertension often requires multiple medications due to salt sensitivity, volume expansion, and isolated systolic hypertension.
Conclusions:
- Calcium channel antagonists are crucial for managing hypertension in diabetic patients.
- Their role is particularly significant in combination therapy for achieving optimal blood pressure control in this population.
Abstract:
Hypertension is twice as common in patients with diabetes compared to those without diabetes. It accounts for up to 75% of cardiovascular disease risk leading to the substantial increase in morbidity and mortality. Control of blood pressure in people with diabetes has been shown in randomized controlled trials to decrease cardiovascular risk and improve outcome especially in preventing stroke. A target blood pressure goal of <130/80 mm Hg is currently recommended for patients with diabetes. However, less than 1/3 of these patients achieve such a goal. This is in part due to the inherent difficulty in controlling blood pressure in these patients where hypertension is usually associated with increased salt sensitivity, volume expansion and isolated systolic hypertension. Therefore, patients with diabetes usually require multiple medications for optimal blood pressure control. Calcium channel antagonists have been shown in large clinical trials to be both safe and effective in controlling blood pressure in diabetic patients and will continue to play a major role in the management of hypertension in this population, particularly in the combination therapy that these patients usually require.
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