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Treating hypertension in type 2 diabetes.

Yoni Grossman1, Gadi Shlomai, Ehud Grossman

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Expert Opinion on Pharmacotherapy
|August 2, 2014
PubMed
Summary

The latest guidelines recommend a blood pressure target of less than 140/90 mmHg for patients with diabetes. Achieving this target involves non-pharmacological methods, with drug therapy and combination treatments initiated as needed for optimal cardiovascular health.

Keywords:
blood pressurediabetes mellitustargettreatment

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Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology

Background:

  • Hypertension and diabetes mellitus frequently coexist, significantly increasing cardiovascular risk in diabetic individuals.
  • Effective blood pressure (BP) management is crucial for mitigating this elevated risk.

Purpose of the Study:

  • To discuss the recommended BP target for patients with diabetes mellitus.
  • To outline strategies for achieving the target BP in diabetic patients.

Main Methods:

  • Review of current guidelines and recent studies on hypertension management in diabetes.
  • Discussion of non-pharmacological and pharmacological treatment approaches.
  • Emphasis on individualized treatment strategies based on patient-specific factors.

Main Results:

  • Recent guidelines advocate for a BP target of < 140/90 mmHg, differing from older recommendations of < 130/80 mmHg.
  • Non-pharmacological interventions are the first line of treatment for all patients.
  • Pharmacological therapy, often requiring combination treatments (e.g., RAAS blockers with calcium antagonists), is initiated if targets are not met.

Conclusions:

  • Individualized treatment plans are essential, considering patient age, comorbidities, and hemodynamic parameters.
  • Combination therapy is frequently necessary to achieve target BP.
  • Integrated management including glycemic and lipid control is vital for reducing cardiorenal risk.