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Related Experiment Videos

Hypertension and diabetes. Clinical problems.

M T Zanella1, R C Santiago, J R de Sá

  • 1Division of Endocrinology, Escola Paulista de Medicina, São Paulo.

Drugs
|January 1, 1988
PubMed
Summary

Treating hypertension in diabetic patients presents challenges. Indoramin showed limited efficacy, while ACE inhibitors offered better blood pressure control but carried risks like postural hypotension. Dopaminergic agents may help manage orthostatic hypotension.

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Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Managing hypertension in diabetic patients is complex.
  • Postural hypotension is a significant concern in this population.

Purpose of the Study:

  • To evaluate antihypertensive agents in diabetic patients.
  • To assess the efficacy and safety of indoramin, ACE inhibitors, and dopaminergic antagonists.

Main Methods:

  • Three studies were conducted involving patients with non-insulin-dependent diabetes and hypertension.
  • Agents evaluated included indoramin, captopril, enalapril, and metoclopramide.
  • Outcomes measured included blood pressure control, blood glucose, HbA1, and adverse events like postural hypotension.

Main Results:

Related Experiment Videos

  • Indoramin achieved blood pressure control in 57% of mild hypertension cases but none with moderate hypertension; postural hypotension occurred in 4 patients.
  • ACE inhibitors (captopril, enalapril) controlled blood pressure in 74-78% of patients, with 2 cases each of postural hypotension and hyperkalemia.
  • Enalapril significantly reduced urinary protein/albumin excretion in 12 patients.
  • Metoclopramide reduced the fall in mean arterial pressure in diabetic patients with orthostatic hypotension.

Conclusions:

  • Indoramin has limited utility for moderate hypertension in diabetics.
  • ACE inhibitors are effective for blood pressure control and may offer renal protection in diabetic hypertensive patients.
  • Dopaminergic antagonists show potential for managing orthostatic hypotension in this group.